Key result
A low post-PCI quantitative flow ratio (<0.86) after drug-coated balloon treatment in small coronary disease was associated with a significantly higher risk of major adverse cardiovascular events (HR 3.632).
Why the study?
Few studies had investigated the prognostic implications of post-PCI QFR and post-PCI ΔQFR in de novo lesions of small coronary disease after drug-coated balloon treatment.
Does post-PCI quantitative flow ratio (QFR) and ΔQFR predict major adverse cardiovascular events in patients with de novo small coronary lesions treated with drug-coated balloons?
Observational (n=286)
Yes
Does post-PCI quantitative flow ratio (QFR) and ΔQFR predict major adverse cardiovascular events in patients with de novo small coronary lesions treated with drug-coated balloons?
Effect estimate: HR 3.632 (95% CI 1.872-7.044)
Absolute Event Rate: 27% vs 5.7%
p-value: p=<0.001
Post-PCI QFR and ΔQFR are independent predictors of MACE in patients with de novo small coronary lesions treated with drug-coated balloons, suggesting their utility for physiological evaluation after DCB.
BACKGROUND: Few studies investigated the implications of post-PCI QFR and post-PCI ΔQFR (absolute increase of QFR) in de novo lesions of small coronary disease after drug-coated balloon (DCB). OBJECTIVES: We sought to investigate the prognostic implications of post-PCI QFR and post-PCI ΔQFR in patients who received DCB only. METHODS: Patients were divided according to the optimal cutoff value of the post-PCI QFR and the post-PCI ΔQFR. The primary outcome was major adverse cardiovascular events (MACE), including target vessel revascularization (TVR), cardiac death, and myocardial infarction (MI). RESULTS: The optimal cutoff values of QFR and ΔQFR for the MACE rate were 0.86 and 0.57, respectively. There were 175 patients (61.2%) with a high QFR (≥ 0.86) and 113 patients (39.5%) with a high ΔQFR (≥ 0.57) after PCI. The MACE rate was significantly higher in patients with a low QFR compared to a high QFR (5.7% vs. 27.0%, hazard ratio [HR]: 3.632, 95% confidence interval [CI]: 1.872 to 7.044, P < 0.001). The MACE rate was higher in patients with a low ΔQFR increase compared to those with high ΔQFR (4.4% vs. 20.2%, HR: 4.700, 95%CI: 2.430 to 9.089, P = 0.001). In multivariable model, a low post-PCI QFR and a low post-PCI ΔQFR was independent predictor of MACE (adjusted HR: 4.071, 95%CI: 2.037 to 8.135, P = 0.001). CONCLUSIONS: After DCB in de novo lesions of small coronary disease, both post-PCI QFR and ΔQFR showed similar prognostic implications in MACE.
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Li et al. (2024) conducted an observational in De novo lesions in small coronary artery disease (n=286). Low post-PCI QFR (< 0.86) vs. High post-PCI QFR (≥ 0.86) was evaluated on Major adverse cardiovascular events (MACE) (HR 3.632, 95% CI 1.872-7.044, p=<0.001). A low post-PCI quantitative flow ratio (<0.86) after drug-coated balloon treatment in small coronary disease was associated with a significantly higher risk of major adverse cardiovascular events (HR 3.632).
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