Quantitative flow ratio virtual stenting and post stenting correlations to post stenting fractional flow reserve measurements from the DOCTORS (Does Optical Coherence Tomography Optimize Results of Stenting) study population

Catheter Cardiovasc Interv. 2020 Nov;96(6):1145-1153. doi: 10.1002/ccd.28615. Epub 2019 Nov 25.

Abstract

Objective: We sought to evaluate the correlations of pre-PCI QFR analysis with virtual PCI called residual QFR and post-PCI QFR compared to post-PCI FFR.

Background: Quantitative flow ratio (QFR) is a computation of fractional flow reserve (FFR) based on angiography without use of a pressure wire. The ability to evaluate post-PCI FFR using pre-PCI QFR analysis with a virtual PCI and the correlation between post-PCI QFR compared to post-PCI FFR remains unknown.

Methods: From the DOCTORS (Does Optical Coherence Tomography Optimize Results of Stenting) study population, we blindly analyzed residual QFR and post-PCI QFR from angiographies and compared them to post-PCI FFR.

Results: Ninety-three post-PCI QFR measurements and 84 pre-PCI residual QFR measurements were compared to post-PCI FFR measurements. No significant difference were observed between mean post-PCI FFR value (0.92 ± 0.05) compared to mean residual (0.93 ± 0.05) QFR and between mean post-PCI FFR value compared to mean post-PCI QFR values were (0.93 ± 0.05) (p > .05 for both). The correlation coefficient of residual QFR with post-PCI FFR was 0.68 (95% CI: 0.53-0.78) and the correlation coefficient of post-PCI-QFR with post-PCI FFR was 0.79 (95% CI: 0.70-0.86).

Conclusions: Residual QFR corresponding to pre-PCI QFR analysis with virtual PCI, and post-PCI QFR analysis, correlated well with post-PCI FFR. Further studies are needed to prospectively validate a QFR-guided PCI strategy.

Keywords: acute coronary syndrome; fractional flow reserve; percutaneous coronary intervention; quantitative flow ratio.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Coronary Angiography*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / therapy*
  • Female
  • Fractional Flow Reserve, Myocardial*
  • France
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / instrumentation*
  • Predictive Value of Tests
  • Randomized Controlled Trials as Topic
  • Reproducibility of Results
  • Retrospective Studies
  • Stents*
  • Time Factors
  • Tomography, Optical Coherence*
  • Treatment Outcome