PCI guided by quantitative flow ratio (QFR) assessments improved two-year clinical outcomes, with incrementally increasing benefits over time, compared with standard angiography guidance, according to findings from the FAVOR III China trial presented Sept. 19 during TCT 2022 and simultaneously published in JACC. Researchers noted that benefits were most pronounced among patients in whom QFR assessment altered the planned revascularization strategy.

In the multicenter trial from China, 3,825 patients were randomized to either QFR-based lesion selection or standard angiography guidance for PCI. At one year, researchers reported improved clinical outcomes compared with conventional angiographic guidance. This latest analysis, presented by Lei Song, MD, sought to determine whether the benefits of QFR guidance persisted at two years, particularly in those patients where QFR changed their revascularization strategy. The primary endpoint was major adverse cardiac events (MACE), a composite of all-cause death, myocardial infarction (MI), or ischemia-driven revascularization (IDR) occurring within two years.

Overall findings showed two-year MACE occurred in 161 out of 1,913 (8.5%) patients in the QFR-guided group and in 237 of the 1,912 (12.5%) patients in the angiography-guided group. According to researchers, this was largely driven by fewer MIs and IDRs within the QFR-guided group. Also of note, "although the two-year MACE rate was lower in the QFR-guided group in both patients with and without revascularization strategy changes, the extent of outcome improvement was greater among those patients in whom the pre-planned PCI strategy was modified by QFR," they said.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Interventions and Imaging, Angiography, Nuclear Imaging

Keywords: Transcatheter Cardiovascular Therapeutics, TCT22, Fractional Flow Reserve, Myocardial, Coronary Angiography, ACC International

< Back to Listings