Post-procedure QFR strongly predicted 5-year MACCEs in CTO patients (AUC 0.80; 95% CI 0.77-0.83; P<0.001), with event rates of 63.9% in the low QFR tertile versus 12.6% in the high QFR tertile.
Cohort (n=616)
Does post-procedure QFR predict long-term MACCEs in patients undergoing PCI for CTO?
Post-procedure QFR assessment is a strong predictor of 5-year MACCEs in patients undergoing PCI for chronic total occlusion.
Effect estimate: AUC 0.80 (95% CI 0.77-0.83)
Absolute Event Rate: 63.9% vs 12.6%
p-value: p=<0.001
Background: QFR, a non-invasive tool using 3D coronary artery imaging and fluid dynamics, helps assess revascularization benefits in patients with coronary chronic total occlusion (CTO). Methods and Results: A retrospective study of 616 CTO patients who underwent PCI for CTO, with QFR assessed post-procedure. In a 5-year follow-up study involving 616 patients, the study used three tertiles (first tertile: QFR ≥ 0.88, second tertile: 0.85 ≤ QFR < 0.88, third tertile: QFR < 0.85) to determine the "cut-off" value. QFR showed strong predictive power with an area under the curve (AUC) of 0.80 (95 % confidence interval: 0.77-0.83, P < 0.001). The occurrence of MACCEs among all participants in the study was 28.4 %. This rate varied across different groups, with 63.9 % in the low QFR tertile, 14.8 % in the middle tertile, and 12.6 % in the high QFR group. During the follow-up period, a variation in the occurrence of MACCEs was observed among the three groups (P < 0.05). Analysis using Kaplan-Meier curves indicated a statistically major difference in the cumulative rates of MACCEs across the groups. Competing risk regression analysis indicated that QFR is negatively associated with all-cause mortality, cardiovascular mortality, and composite MACCEs. Conclusion: The study found a high prognostic value of physiological assessment using QFR after successful CTO intervention.
Xin et al. (Tue,) conducted a cohort in Coronary chronic total occlusion (CTO) (n=616). Post-procedure Quantitative Flow Ratio (QFR) assessment vs. High QFR (≥ 0.88) was evaluated on Major Adverse Cardiac and Cerebrovascular Events (MACCEs) (AUC 0.80, 95% CI 0.77-0.83, p=<0.001). Post-procedure QFR strongly predicted 5-year MACCEs in CTO patients (AUC 0.80; 95% CI 0.77-0.83; P<0.001), with event rates of 63.9% in the low QFR tertile versus 12.6% in the high QFR tertile.
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