Prognostic value of quantitative flow ratio in patients with coronary heart disease after percutaneous coronary intervention therapy: a meta-analysis

Front Cardiovasc Med. 2023 Aug 7:10:1164290. doi: 10.3389/fcvm.2023.1164290. eCollection 2023.

Abstract

Background: Coronary atherosclerotic heart disease is one of the most serious health and life-threatening diseases. There is no doubt that despite the increasing number of assessment methods used clinically, the prognosis assessment is still not ideal, and newer assessment methods are needed.

Objective: To investigate the predictive value of quantitative flow ratio (QFR) for adverse events (vessel-oriented composite endpoint events/target lesion failure) in patients after percutaneous coronary intervention (PCI).

Method: Eight studies involving 4,173 patients (5,688 vascular lesions) were included. These are studies on the relationship between QFR values and prognosis of adverse cardiac events after PCI. This meta-analysis was performed after quality assessment and data extraction of clinical trials data that met the inclusion criteria.

Result: Each of the eight studies described the cut-off values for the best predictive ability of post-PCI QFR and the hazard ratio (HR) between QFR values and adverse events, respectively. The pooled HR of these studies was 4.72 (95% CI: 3.29-6.75). Concurrently, lower post-PCI QFR values were associated with the occurrence of individual clinical events (cardiac death/myocardial infarction/target vessel revascularization), with relative risk values of 6.51 (95% CI: 4.96-8.53), 4.83 (95% CI: 3.08-7.57), and 4.21 (95% CI: 2.66-6.68), respectively.

Conclusion: QFR may have great potential in the assessment of prognosis. It is necessary to measure QFR value after PCI. A lower QFR value after PCI was an important predictor for experiencing adverse events.

Keywords: coronary heart disease; meta; percutaneous coronary intervention; prognosis; quantitative flow ratio.

Publication types

  • Review

Grants and funding

This work was supported by the Doctor Start-up Fund of Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College (No. 19–236), and the Key Project of the Provincial Health Department, No. 20-021, Coronary Atherectomy for the Treatment of Coronary Artery Disease.