Association of quantitative flow ratio with in-stent restenosis in patients with unstable angina undergoing percutaneous coronary intervention

OBJECTIVE: To investigate the association of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) with in-stent restenosis (ISR) in patients with unstable angina. MATERIALS AND METHODS: Patients treated with PCI and follow-up for ISR were divided into a poor QFR group (QFR < 0.91) and a good QFR group with (QFR ≥ 0.91). All clinical data were analyzed. RESULTS: Among 143 patients enrolled, 57 (39.9%) patients were in the poor QFR group and 86 (60.1%) in the good QFR group. After stenting, the stenosis was decreased to 0 from ≥80% before PCI. At 10-month follow-up, the incidence of ISR in the good QFR group was 6.9%, significantly lower than 33.9% in the poor QFR group (P < 0.05). QFR < 0.91 was a significant (P = 0.002) risk factor for ISR, 4.25 times that of patients with QFR ≥ 0.91. After adjusting for age and sex, the risk of developing ISR in patients with poor QFR was 4.51 times that in patients with good QFR [95% confidence interval (CI): 1.76-11.54, P = 0.002], and QFR < 0.91 (adjusted risk ratio: 6.57, 95% CI: 2.45-17.60, P < 0.001) and diabetes (adjusted risk ratio: 7.23, 95% CI: 2.81-18.60, P < 0.001) were two independent risk factors for ISR. CONCLUSION: A positive linear relationship exists between QFR and ISR after adjusting for age and sex, and poor QFR < 0.91 after PCI is a significant independent risk factor for ISR among unstable angina patients undergoing PCI.