Prognostic Value of Postpercutaneous Coronary Intervention Murray-Law-Based Quantitative Flow Ratio
Year: 2025
Type: article
Abstract: Background: Coronary physiology measured by fractional flow reserve (FFR) is superior to angiography for assessing the efficacy of percutaneous coronary intervention (PCI). Yet, the clinical adoption of post-PCI FFR is limited. Murray law-based quantitative flow ratio (μQFR) may represent a promising alternative, as it can quickly compute FFR from a single angiographic view. Objectives: The authors aimed to investigate the potential role of post-PCI μQFR in predicting clinical outcomes. Methods: This was a post hoc blinded analysis of the FLAVOUR trial. Patients with angiographically intermediate lesions randomized 1:1 to receive FFR or intravascular ultrasound-guided PCI were included. Post-PCI μQFR was assessed in successfully stented vessels, blinded to clinical outcomes. Suboptimal physiological outcome post-PCI was defined a priori as post-PCI μQFR <0.90. The primary endpoint was 2-year target vessel failure, including cardiac death, target vessel myocardial infarction, and target vessel revascularization. Secondary endpoints included the diagnostic concordance of pre-PCI μQFR with FFR in the FFR-guidance arm. Results: 0.022). Pre-PCI μQFR was obtained in 877 of 919 vessels (feasibility 95.4%), showing 90% accuracy, 82% sensitivity, and 94% specificity for identifying physiologically significant stenosis defined by pre-PCI FFR ≤0.80. Conclusions: In patients with intermediate lesions who underwent PCI with contemporary imaging or physiology guidance, lower post-PCI μQFR values predict subsequent adverse events. (Fractional FLow Reserve And IVUS for Clinical OUtcomes in Patients With InteRmediate Stenosis [FLAVOUR]; NCT02673424).
Source: JACC Asia
Authors: Daixin Ding, Jinlong Zhang, Peng Wu, Zhiqing Wang, Huiping Shi, Wei Yu, Xinyang Hu, Jeehoon Kang, Joo-Yong Hahn, Chang-Wook Nam, Joon-Hyung Doh, Bong-Ki Lee, Weon Kim, Jinyu Huang, Fan Jiang, Hao Zhou, Peng Chen, Lijiang Tang, Wenbing Jiang, Xiaomin Chen, Wenming He, Sung Gyun Ahn, Myeong-Ho Yoon, Ung Kim, You-Jeong Ki, Eun-Seok Shin, Seung-Jea Tahk, Jun Pu, William Wijns, Jian’an Wang, Bon-Kwon Koo, Shengxian Tu
Institutions: Shanghai Jiao Tong University, Ollscoil na Gaillimhe – University of Galway, Renji Hospital, Second Affiliated Hospital of Zhejiang University, Zhejiang University, Union Hospital, Seoul National University, Seoul National University Hospital, Samsung Medical Center, Sungkyunkwan University, Keimyung University Dongsan Medical Center, Inje University Ilsan Paik Hospital, Kangwon National University Hospital, Kyung Hee University, Affiliated Hangzhou First People's Hospital, Westlake University, School of Medicine, Hangzhou Normal University, Affiliated Hospital of Hangzhou Normal University, First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Zhejiang Hospital, Ningbo First Hospital, Ningbo University, Ningbo University Affiliated Hospital, Wonju Severance Christian Hospital, Ajou University Hospital, Yeungnam University Medical Center, Eulji University Uijeongbu Eulji Medical Center, University of Ulsan, Ulsan University Hospital
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,084
OpenAlex ID: W4406138934