Key result
Lower post-PCI QFR is linked to a ~372% higher risk of adverse events.
Why the study?
Prognosis assessment after PCI remains suboptimal despite existing clinical methods, motivating evaluation of newer assessment tools like quantitative flow ratio (QFR).
Does a lower post-PCI quantitative flow ratio (QFR) predict adverse cardiovascular events in patients with coronary heart disease undergoing percutaneous coronary intervention?
Meta-Analysis (n=4,173)
Does a lower post-PCI quantitative flow ratio (QFR) predict adverse cardiovascular events in patients with coronary heart disease undergoing percutaneous coronary intervention?
Hazard Ratio: 4.72 (95% CI 3.29–6.75)
A lower quantitative flow ratio (QFR) after percutaneous coronary intervention is a strong independent predictor of adverse cardiovascular events, including target vessel revascularization and cardiac death.
Supports post-PCI QFR for risk stratification after revascularization; confirms its prognostic value in meta-analysis.
Background: Coronary atherosclerotic heart disease is one of the most serious health and life-threatening diseases. There is no doubt that despite the increasing number of assessment methods used clinically, the prognosis assessment is still not ideal, and newer assessment methods are needed. Objective: To investigate the predictive value of quantitative flow ratio (QFR) for adverse events (vessel-oriented composite endpoint events/target lesion failure) in patients after percutaneous coronary intervention (PCI). Method: Eight studies involving 4,173 patients (5,688 vascular lesions) were included. These are studies on the relationship between QFR values and prognosis of adverse cardiac events after PCI. This meta-analysis was performed after quality assessment and data extraction of clinical trials data that met the inclusion criteria. Result: Each of the eight studies described the cut-off values for the best predictive ability of post-PCI QFR and the hazard ratio (HR) between QFR values and adverse events, respectively. The pooled HR of these studies was 4.72 (95% CI: 3.29-6.75). Concurrently, lower post-PCI QFR values were associated with the occurrence of individual clinical events (cardiac death/myocardial infarction/target vessel revascularization), with relative risk values of 6.51 (95% CI: 4.96-8.53), 4.83 (95% CI: 3.08-7.57), and 4.21 (95% CI: 2.66-6.68), respectively. Conclusion: QFR may have great potential in the assessment of prognosis. It is necessary to measure QFR value after PCI. A lower QFR value after PCI was an important predictor for experiencing adverse events.
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Chen et al. (2023) conducted a meta-analysis in Coronary heart disease after percutaneous coronary intervention (n=4,173). Low post-PCI quantitative flow ratio (QFR) vs. High post-PCI QFR was evaluated on Adverse events (vessel-oriented composite endpoint events or target lesion failure) (HR 4.72, 95% CI 3.29-6.75). A lower quantitative flow ratio after percutaneous coronary intervention was associated with a significantly higher risk of adverse events, with a pooled HR of 4.72.
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