What is the clinical evidence from this study?

Study design: RCT. Population: Coronary artery disease (n=3825). Intervention: QFR-guided strategy vs. Angiography-guided strategy. Primary outcome: Major adverse cardiac events (composite of death from any cause, myocardial infarction, or ischaemia-driven revascularisation) (HR 0.65, 95% CI 0.51 to 0.83, p=0.0004).

What question did this study set out to answer?

To determine whether lesion selection for percutaneous coronary intervention using the quantitative flow ratio improves 1-year clinical outcomes compared with standard visual angiographic assessment.

September 10, 2026The Lancet

Angiographic quantitative flow ratio-guided coronary intervention (FAVOR III China): a multicentre, randomised, sham-controlled trial

View Full Paper

Ask AI

Bookmark

Key result

QFR-guided PCI cuts 1-year MACE by ~35% compared to standard angiography.

HR 0.65
95% CI 0.51 to 0.83
P=0.0004
n=3,825

Why the study?

Does a QFR-guided strategy for lesion selection reduce the 1-year rate of major adverse cardiac events compared to standard angiography guidance in patients undergoing PCI?

Population

3,825 adults with stable or unstable angina pectoris or myocardial infarction at least 72 h before…

Comparison

Quantitative flow ratio-guided strategy vs Angiography-guided strategy

Design

RCT, Randomly assigned, Blinded, sham-controlled

Follow-up

1-year

Discussion

Member takes

Key expert perspectives

Captured external expert commentary on this paper, strongest first. Original sources are linked where available.

GWGregg W. StoneDirector of Academic Affairs, Mount Sinai Health System

“For the first time we have clinical validation that lesion selection with this method improves outcomes for patients with coronary artery disease undergoing stent treatment. By avoiding the time, complications, and extra resources required to measure lesion severity using a pressure wire, this simpler technique should serve to greatly expand the use of physiology in patients undergoing cardiac catheterization procedures.”

Mount Sinai Health SystemNews Coverage

Implication

A QFR-guided strategy for lesion selection during PCI significantly reduces 1-year major adverse cardiac events compared to standard visual angiography guidance.

Key Points

To determine whether lesion selection for percutaneous coronary intervention using the quantitative flow ratio improves 1-year clinical outcomes compared with standard visual angiographic assessment.
Multicentre, blinded, randomised, sham-controlled trial conducted at 26 hospitals in China in 3825 intention-to-treat patients with coronary artery disease (NCT03656848).
Participants were randomly assigned to a quantitative flow ratio-guided strategy (PCI performed only if QFR ≤0.80; n=1913) or standard visual angiography-guided strategy (n=1912), with participants and clinical assessors masked to treatment allocation.
The primary endpoint of 1-year major adverse cardiac events occurred in 5.8% (110 participants) of the QFR-guided group versus 8.8% (167 participants) of the angiography-guided group (HR 0.65 [95% CI 0.51 to 0.83]; p=0.0004).
The 3.0% absolute reduction in primary events (95% CI -4.7 to -1.4) was driven primarily by fewer myocardial infarctions and ischaemia-driven revascularisations in the QFR-guided cohort.

Study Design

Type

RCT (n=3,825)

Blinding

Double-blind

Randomization

Randomized

Multicenter

Yes

Structured PICO

Does a QFR-guided strategy for lesion selection reduce the 1-year rate of major adverse cardiac events compared to standard angiography guidance in patients undergoing PCI?

Population

3,825 patients aged ≥18 years with coronary artery disease and at least one 50-90% coronary stenosis, followed for 1 year.

Intervention

Quantitative flow ratio (QFR)-guided strategy (PCI performed only if QFR ≤0.80)

Comparator

Angiography-guided strategy (PCI based on standard visual angiographic assessment)

Outcome

1-year rate of major adverse cardiac events, a composite of death from any cause, myocardial infarction, or ischaemia-driven revascularisationcomposite

Main Result

Hazard Ratio: 0.65 (95% CI 0.51–0.83)

Absolute Event Rate: 5.8% vs 8.8%

Absolute Risk Reduction: 3%

p-value: p=0.0004

A QFR-guided strategy for lesion selection during PCI significantly reduces 1-year major adverse cardiac events compared to standard visual angiography guidance.

Cite This Study

A 2021 study conducted an RCT in Coronary artery disease (n=3,825). QFR-guided strategy vs. Angiography-guided strategy was evaluated on Major adverse cardiac events (composite of death from any cause, myocardial infarction, or ischaemia-driven revascularisation) (HR 0.65, 95% CI 0.51 to 0.83, p=0.0004). A QFR-guided strategy for PCI lesion selection reduced 1-year major adverse cardiac events compared with standard angiography guidance (5.8% vs 8.8%; HR 0.65; 95% CI 0.51-0.83; p=0.0004).

synapsesocial.com/papers/6aa2ca7eb8bd820bf0fe530d https://doi.org/10.1016/s0140-6736(21)02248-0

View Full Paper

Ask AI

Bookmark

Implication

A QFR-guided strategy for lesion selection during PCI significantly reduces 1-year major adverse cardiac events compared to standard visual angiography guidance.

Angiographic quantitative flow ratio-guided coronary intervention (FAVOR III China): a multicentre, randomised, sham-controlled trial

Discussion

Member takes

Key expert perspectives

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Angiographic quantitative flow ratio-guided coronary intervention (FAVOR III China): a multicentre, randomised, sham-controlled trial

Discussion

Member takes

Key expert perspectives

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider