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Authors: Buono, Andrea
Mühlenhaus, Annika
Schäfer, Tabitha
Trieb, Ann-Kristin
Schmeißer, Julian
Koppe, Franziska
Münzel, Thomas
Anadol, Remzi
Gori, Tommaso
Title: QFR predicts the incidence of long-term adverse events in patients with suspected CAD : feasibility and reproducibility of the method
Online publication date: 10-Jun-2020
Language: english
Abstract: AIMS: We evaluate feasibility and reproducibility of post hoc quantitative flow ratio (QFR) measurements and their prognostic predictive power during long-term follow-up. METHODS AND RESULTS: Between 2010 and 2012, 167 patients without angiographic evidence of significant stenoses were enrolled in a prospective registry. Of these patients, 96% presented 7 years follow-up data. QFR was measured post hoc by three certified investigators. QFR analysis was feasible in 71% of left anterior descending (LAD), 72% of left circumflex (LCX), and 61% of right (RCA) coronaries for a total of 350 measurements repeated in triplicate. Coefficients of variation were 2.1% for RCA and LCX, and 2.8% for the LAD (quartile coefficients of dispersion respectively 1.5, 1.4, and 1.3). QFR ≤0.80 was recorded in 25 patients (27 vessels, in 74% of the cases LAD). A total of 86 major adverse cardiovascular and cerebrovascular events were observed in 76 patients. QFR ≤0.80 in at least one of the three vessels was the strongest predictor of events (HR 3.14, 95%CI 1.78–5.54, p = 0.0001). This association was maintained in several sensitivity analyses. CONCLUSIONS: QFR reproducibility is acceptable, even when analysis is performed post hoc. A pathological QFR is not rare in patients without angiographic evidence of significant stenosis and is a predictor of incident events during long-term follow-up. Condensed Abstract: In a post hoc analysis of 167 patients without evidence of angiographic significant stenosis, the presence of QFR value ≤0.80 in at least one of the three coronary vessels showed to be the strongest predictor of major adverse cardiovascular and cerebrovascular events during long-term follow-up. QFR reproducibility have been shown to be acceptable among experienced operators. Keywords: fractional flow reserve; coronary artery disease; coronary interventions; Quantitative flow reserve
DDC: 610 Medizin
610 Medical sciences
Institution: Johannes Gutenberg-Universität Mainz
Department: FB 04 Medizin
Place: Mainz
URN: urn:nbn:de:hebis:77-publ-598682
Version: Published version
Publication type: Zeitschriftenaufsatz
License: CC BY
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Journal: Journal of Clinical Medicine
Pages or article number: Art. 220
Publisher: MDPI
Publisher place: Basel
Issue date: 2020
ISSN: 2077-0383
Publisher URL:
Publisher DOI: 10.3390/jcm9010220
Appears in collections:JGU-Publikationen

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