The pooled analysis of 2,933 patients and 3,335 vessels across 16 studies underscores the growing evidence supporting the application of QFR in specific contexts for assessing the severity of coronary lesions. Key findings include strong concordance between QFR and FFR in stable patients, suggesting the potential to avoid FFR in over 80% of these cases, reducing procedural risks. QFR reliably evaluated the burden of CAD, indicating its independent prognostic value. Notably, QFR demonstrated efficacy in preventing unnecessary staged procedures, particularly in nonculprit lesions post-primary PCI. QFR’s utility extends to identifying myocardial ischemia, showing high accuracy in correlation with FFR and iFR.
Prognostically, low QFR values indicate more severe CAD and poorer outcomes, but they also suggest increased benefit post-PCI. QFR’s potential in nonculprit lesions, particularly after acute myocardial infarction, holds promise, with ongoing studies exploring its guidance in PCI for nonculprit lesions. In conclusion, QFR exhibits excellent correlation with FFR, optimal predictive value for functional significance, and promising prognostic implications, warranting further exploration in diverse clinical scenarios.
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