TY - JOUR
T1 - 2-Year Outcomes of Angiographic Quantitative Flow Ratio-Guided Coronary Interventions
AU - FAVOR III China study group
AU - Song, Lei
AU - Xu, Bo
AU - Tu, Shengxian
AU - Guan, Changdong
AU - Jin, Zening
AU - Yu, Bo
AU - Fu, Guosheng
AU - Zhou, Yujie
AU - Wang, Jian'an
AU - Chen, Yundai
AU - Pu, Jun
AU - Chen, Lianglong
AU - Qu, Xinkai
AU - Yang, Junqing
AU - Liu, Xuebo
AU - Guo, Lijun
AU - Shen, Chengxing
AU - Zhang, Yaojun
AU - Zhang, Qi
AU - Pan, Hongwei
AU - Zhang, Rui
AU - Liu, Jian
AU - Zhao, Yanyan
AU - Wang, Yang
AU - Dou, Kefei
AU - Kirtane, Ajay J.
AU - Wu, Yongjian
AU - Wijns, William
AU - Yang, Weixian
AU - Leon, Martin B.
AU - Qiao, Shubin
AU - Stone, Gregg W.
N1 - Funding Information:
The authors appreciate all of the participating patients for their contributions to the trial. The authors also thank all of the physicians and nurses who cared for the patients, and all the clinical and research staff who assisted with the study process.
Publisher Copyright:
© 2022 American College of Cardiology Foundation
PY - 2022/11/29
Y1 - 2022/11/29
N2 - Background: In the multicenter, randomized, sham-controlled FAVOR (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients with Coronary Artery Disease) III China trial, quantitative flow ratio (QFR)–based lesion selection improved 1-year clinical outcomes compared with conventional angiographic guidance for percutaneous coronary intervention (PCI). Objectives: The purpose of this study was to determine whether the benefits of QFR guidance persist at 2 years, particularly for patients in whom QFR changed the revascularization strategy. Methods: Eligible patients were randomized to a QFR-guided strategy (PCI performed only if QFR ≤0.80) or a standard angiography-guided strategy. Major adverse cardiac events (MACE), a composite of all-cause death, myocardial infarction (MI), or ischemia-driven revascularization occurring within 2 years were analyzed in the intention-to-treat population. Results: Among 3,825 randomized participants, 2-year MACE occurred in 161 of 1,913 (8.5%) patients in the QFR-guided group and in 237 of 1,912 (12.5%) patients in the angiography-guided group (HR: 0.66; 95% CI: 0.54-0.81; P < 0.0001), driven by fewer MIs (4.0% vs 6.8%; HR: 0.58; 95% CI: 0.44-0.77; P = 0.0002) and ischemia-driven revascularizations (4.2% vs 5.8%; HR: 0.71; 95% CI: 0.53-0.95; P = 0.02) in the QFR-guided group. Landmark analysis showed consistent results within the first year and between 1-2 years (Pint = 0.99). Although the 2-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 (Pint = 0.009) among those patients in whom the preplanned PCI strategy was modified by QFR. Conclusions: QFR-guided lesion selection improved 2-year clinical outcomes compared with standard angiography guidance. The benefits were most pronounced among patients in whom QFR assessment altered the planned revascularization strategy.
AB - Background: In the multicenter, randomized, sham-controlled FAVOR (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients with Coronary Artery Disease) III China trial, quantitative flow ratio (QFR)–based lesion selection improved 1-year clinical outcomes compared with conventional angiographic guidance for percutaneous coronary intervention (PCI). Objectives: The purpose of this study was to determine whether the benefits of QFR guidance persist at 2 years, particularly for patients in whom QFR changed the revascularization strategy. Methods: Eligible patients were randomized to a QFR-guided strategy (PCI performed only if QFR ≤0.80) or a standard angiography-guided strategy. Major adverse cardiac events (MACE), a composite of all-cause death, myocardial infarction (MI), or ischemia-driven revascularization occurring within 2 years were analyzed in the intention-to-treat population. Results: Among 3,825 randomized participants, 2-year MACE occurred in 161 of 1,913 (8.5%) patients in the QFR-guided group and in 237 of 1,912 (12.5%) patients in the angiography-guided group (HR: 0.66; 95% CI: 0.54-0.81; P < 0.0001), driven by fewer MIs (4.0% vs 6.8%; HR: 0.58; 95% CI: 0.44-0.77; P = 0.0002) and ischemia-driven revascularizations (4.2% vs 5.8%; HR: 0.71; 95% CI: 0.53-0.95; P = 0.02) in the QFR-guided group. Landmark analysis showed consistent results within the first year and between 1-2 years (Pint = 0.99). Although the 2-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 (Pint = 0.009) among those patients in whom the preplanned PCI strategy was modified by QFR. Conclusions: QFR-guided lesion selection improved 2-year clinical outcomes compared with standard angiography guidance. The benefits were most pronounced among patients in whom QFR assessment altered the planned revascularization strategy.
KW - angiography
KW - coronary artery disease
KW - percutaneous coronary intervention
KW - quantitative flow ratio
UR - http://www.scopus.com/inward/record.url?scp=85141746085&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2022.09.007
DO - 10.1016/j.jacc.2022.09.007
M3 - Article
C2 - 36424680
AN - SCOPUS:85141746085
VL - 80
SP - 2089
EP - 2101
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 22
ER -