Key result
Quantitative flow ratio (QFR) to guide PCI decisions was associated with a decreased risk of MACE compared with coronary angiography (RR 0.68; 95% CI 0.56-0.82).
Why the study?
Evidence regarding the comparative efficacy of different methods to determine the significance of coronary stenoses in the catheterization laboratory was lacking.
Do physiological or imaging methods (QFR, FFR, iFR, intravascular imaging) reduce MACE compared to coronary angiography in patients considered for PCI?
Population
16,333 participants with greater than 30% stenoses considered for PCI across 15 randomized trials
Comparison
Methods guiding the decision to perform PCI (QFR, FFR, iFR, intravascular imaging, CA)
Design
Systematic review and frequentist random-effects network meta-analysis
Follow-up
Mean weighted follow-up of 34 months
Authors
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QFR may warrant consideration for PCI guidance to lower MACE; extends network meta-analysis evidence beyond FFR and iFR.
Meta-Analysis (n=16,333)
Do physiological or imaging methods (QFR, FFR, iFR, intravascular imaging) reduce MACE compared to coronary angiography in patients considered for PCI?
Relative Risk: 0.68 (95% CI 0.56–0.82)
In a network meta-analysis, guiding PCI decisions with quantitative flow ratio (QFR) was associated with a lower risk of MACE compared to coronary angiography, FFR, and iFR.
d’Entremont et al. (2024) conducted a meta-analysis in Coronary stenoses (n=16,333). Quantitative flow ratio (QFR) vs. Coronary angiography (CA), fractional flow reserve (FFR), and instantaneous wave-free ratio (iFR) was evaluated on Major adverse cardiovascular events (MACE) (RR 0.68, 95% CI 0.56 to 0.82). Quantitative flow ratio (QFR) to guide PCI decisions was associated with a decreased risk of MACE compared with coronary angiography (RR 0.68; 95% CI 0.56-0.82).
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