QFR measurements post CTO percutaneous coronary intervention: Can the long term outcome be predicted?

Background: QFR, a non-invasive tool using 3D coronary artery imaging and fluid dynamics, helps assess revascularization benefits in patients with coronary chronic total occlusion (CTO). Methods and Results: A retrospective study of 616 CTO patients who underwent PCI for CTO, with QFR assessed post-...

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Main Authors: Yanguo Xin, Jiayu Li, Xiaosong Ding, Xuhe Gong, Li Zhou, Hui Chen
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:International Journal of Cardiology: Heart & Vasculature
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352906725000922
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author Yanguo Xin
Jiayu Li
Xiaosong Ding
Xuhe Gong
Li Zhou
Hui Chen
author_facet Yanguo Xin
Jiayu Li
Xiaosong Ding
Xuhe Gong
Li Zhou
Hui Chen
author_sort Yanguo Xin
collection DOAJ
description Background: QFR, a non-invasive tool using 3D coronary artery imaging and fluid dynamics, helps assess revascularization benefits in patients with coronary chronic total occlusion (CTO). Methods and Results: A retrospective study of 616 CTO patients who underwent PCI for CTO, with QFR assessed post-procedure. In a 5-year follow-up study involving 616 patients, the study used three tertiles (first tertile: QFR ≥ 0.88, second tertile: 0.85 ≤ QFR < 0.88, third tertile: QFR < 0.85) to determine the “cut-off” value. QFR showed strong predictive power with an area under the curve (AUC) of 0.80 (95 % confidence interval: 0.77–0.83, P < 0.001). The occurrence of MACCEs among all participants in the study was 28.4 %. This rate varied across different groups, with 63.9 % in the low QFR tertile, 14.8 % in the middle tertile, and 12.6 % in the high QFR group. During the follow-up period, a variation in the occurrence of MACCEs was observed among the three groups (P < 0.05). Analysis using Kaplan-Meier curves indicated a statistically major difference in the cumulative rates of MACCEs across the groups. Competing risk regression analysis indicated that QFR is negatively associated with all-cause mortality, cardiovascular mortality, and composite MACCEs. Conclusion: The study found a high prognostic value of physiological assessment using QFR after successful CTO intervention.
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spelling doaj-art-1672ffa4ff384879ab45a18f6b37587f2025-08-20T02:56:29ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672025-08-015910168910.1016/j.ijcha.2025.101689QFR measurements post CTO percutaneous coronary intervention: Can the long term outcome be predicted?Yanguo Xin0Jiayu Li1Xiaosong Ding2Xuhe Gong3Li Zhou4Hui Chen5Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaCorresponding authors at: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong’an Road, Xicheng District, Beijing 100050, China.; Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaCorresponding authors at: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong’an Road, Xicheng District, Beijing 100050, China.; Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaBackground: QFR, a non-invasive tool using 3D coronary artery imaging and fluid dynamics, helps assess revascularization benefits in patients with coronary chronic total occlusion (CTO). Methods and Results: A retrospective study of 616 CTO patients who underwent PCI for CTO, with QFR assessed post-procedure. In a 5-year follow-up study involving 616 patients, the study used three tertiles (first tertile: QFR ≥ 0.88, second tertile: 0.85 ≤ QFR < 0.88, third tertile: QFR < 0.85) to determine the “cut-off” value. QFR showed strong predictive power with an area under the curve (AUC) of 0.80 (95 % confidence interval: 0.77–0.83, P < 0.001). The occurrence of MACCEs among all participants in the study was 28.4 %. This rate varied across different groups, with 63.9 % in the low QFR tertile, 14.8 % in the middle tertile, and 12.6 % in the high QFR group. During the follow-up period, a variation in the occurrence of MACCEs was observed among the three groups (P < 0.05). Analysis using Kaplan-Meier curves indicated a statistically major difference in the cumulative rates of MACCEs across the groups. Competing risk regression analysis indicated that QFR is negatively associated with all-cause mortality, cardiovascular mortality, and composite MACCEs. Conclusion: The study found a high prognostic value of physiological assessment using QFR after successful CTO intervention.http://www.sciencedirect.com/science/article/pii/S2352906725000922Coronary chronic total occlusionPercutaneous coronary interventionQuantitative flow ratioMajor adverse cardiac and cerebral events
spellingShingle Yanguo Xin
Jiayu Li
Xiaosong Ding
Xuhe Gong
Li Zhou
Hui Chen
QFR measurements post CTO percutaneous coronary intervention: Can the long term outcome be predicted?
International Journal of Cardiology: Heart & Vasculature
Coronary chronic total occlusion
Percutaneous coronary intervention
Quantitative flow ratio
Major adverse cardiac and cerebral events
title QFR measurements post CTO percutaneous coronary intervention: Can the long term outcome be predicted?
title_full QFR measurements post CTO percutaneous coronary intervention: Can the long term outcome be predicted?
title_fullStr QFR measurements post CTO percutaneous coronary intervention: Can the long term outcome be predicted?
title_full_unstemmed QFR measurements post CTO percutaneous coronary intervention: Can the long term outcome be predicted?
title_short QFR measurements post CTO percutaneous coronary intervention: Can the long term outcome be predicted?
title_sort qfr measurements post cto percutaneous coronary intervention can the long term outcome be predicted
topic Coronary chronic total occlusion
Percutaneous coronary intervention
Quantitative flow ratio
Major adverse cardiac and cerebral events
url http://www.sciencedirect.com/science/article/pii/S2352906725000922
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AT xiaosongding qfrmeasurementspostctopercutaneouscoronaryinterventioncanthelongtermoutcomebepredicted
AT xuhegong qfrmeasurementspostctopercutaneouscoronaryinterventioncanthelongtermoutcomebepredicted
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