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 - 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
SN - 0735-1097
VL - 80
SP - 2089
EP - 2101
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 22
ER -