The latest developments of Medis QFR® - July 2024

Reading time: 10 mins
Written on: July 18, 2024
Given the regular posts of peer-reviewed scientific publications on the Medis QFR®, it is clear that this angio-based solution for coronary physiology is extensively used in clinical research and practice. We would like to share these publications with you so that you remain up-to-date about the research that is ongoing worldwide with this innovative solution, whereby each time new clinical applications are being tested, validated, tried-out in particular populations. In this July edition of the Medis QFR® blog article we are proud to share five publications with you.

Concordance between vessel-specific and vascular territory coronary functional assessment: a comparison of quantitative flow ratio and myocardial perfusion scintigraphy.

Dr. L. de Moura Santos and co-authors under the supervision of Dr. A.A.C. Abizaid from the Heart Institute (Incor) at the University of Sao Paulo Medical School in Brazil published this interesting paper in Catheterization and Cardiovascular Interventions. This is a retrospective analysis of patients at the Univ of Sao Paulo who underwent invasive coronary angiography and myocardial perfusion scintigraphy (MPS); a total of 2010 coronary territories from 670 patients were analyzed. MPS are under the curve for QFR≤0.80 was 0.637. Concordance rate was 52.5%, partial 29.1%, poor 15.8% and total discordance 2.6%. Most concordance was in patients without CAD or single vessel disease. Predictors for discordance included higher atherosclerotic burden and MPS perfusion defects (SSS≥4). After 1400 days, no significant in death/MI was observed based on MPS assessment, but Leaman score, functional Leaman score and average QFR identified higher risk patients.

QFR for the revascularization of nonculprit vessels in MI patients. Insights from the FIRE trial.

Dr. A. Erriguez and co-authors from the FIRE Trial under the guidance of Dr. Simone Biscaglia, Ferrara University Medical Center in Italy, published this exciting paper in JACC Interventions on the same day that the results were presented in a HotLine Session at the EuroPCI congress 2024 in Paris. This is a prespecified subanalysis (QFiRe study) of the FIRE trial, which randomized older MI patients to culprit-only or physiology-guided complete revascularization. QFR was measured on 903 nonculprit vessels from 685 patients in the culprit-only arm. 40.5% of non-culprit vessels showed a QFR ≤ 0.80, which emerged as an independent predictor of VOCE. In the complete arm, QFR was used in 320 vessels (35.2%) non-culprit vessels to guide revascularization. When compared with propensity-matched non-culprit vessels in which treatment was guided by wire-based functional assessment, no significant difference was observed. The authors concluded that this subanalysis provides evidence supporting the safety and efficacy of QFR-guided interventions for the treatment of nonculprit vessels in MI patients.

Complete revascularization in AMI. Igniting insights beyond the flames of FIRE.

This is an excellent Editorial Comment on the paper by Dr Erriquez (QFiRe trial) written by Prof B-K Koo from Seoul National University Hospital in Korea.

Quantitative flow ratio and graft outcomes of coronary bypass grafting surgery: a retrospective study.

Dr. M. Tian from the Dept of Surgery, National Center for Cardiovascular Disease and Fuwai hospital, in Beijing and co-authors published this very interesting paper in the Journal of Thoracic and Cardiovascular Surgery. This is a retrospective study including 2024 patients with 2307 arterial grafts and 5125 vein grafts. 3D QFR calculation was conducted in eligible coronary arteries; a threshold of QFR0.80 group compared to the QFR<0.80 group. No significant association was observed in the vein grafts. Apparently insignificant coronary stenosis leads to competitive flow in CABG. The results suggest that QFR analysis could potentially guide bypass strategies.

Can routine quantitative flow ratio guide coronary artery bypass grafting?

This is an Editorial Comment on the paper by Tian M., written by J.M. O’Brien and co-authors from Victorian Heart Institute in Melbourne, Australia. The authors believe that the QFR is in an excellent position to address additional questions in prospective trials given its simplicity and non-invasive nature.

Share this blog on:

Would you like to receive our blogs directly in your email?

Would you like to get our latest news, insights, blogs or tips & tricks directly into your mailbox? Please sign up for our newsletter