Diagnostic Performance of In‐Procedure Angiography‐Derived Quantitative Flow Reserve Compared to Pressure‐Derived Fractional Flow Reserve

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Written on: February 8, 2024
The FAVOR II E‐J and FAVOR II China studies, pioneering in‐procedure QFR assessment, revealed compelling results. FAVOR II E-J was a prospective, observational, investigator‐initiated study. Patients with stable angina pectoris were enrolled in 11 international centers.
FAVOR II E‐J demonstrated QFR’s superior specificity and sensitivity compared to 2D‐QCA with FFR as a reference standard. Notably, QFR was not only feasible but also faster than FFR during coronary angiography. Diagnostic performance was comparable to FAVOR II China, showcasing improved precision over early offline QFR studies. Unlike conventional computational fluid dynamics methods, FAVOR II studies proved real-time FFR computation’s feasibility, speed, and accuracy. Given the rising clinical adoption of FFR, QFR emerges as a promising alternative, overcoming barriers like cost and the need for hyperemia. Core-lab analysis affirmed QFR’s agreement with FFR. QFR’s superiority over quantitative coronary angiography in assessing coronary artery stenosis positions it as a valuable tool, particularly where access to pressure wires is limited. In conclusion, in‐procedure QFR is clinically feasible, outperforming angiographic assessment, and has the potential to reshape the landscape of physiological lesion evaluation.

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