Influence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real‑world patients
Written on: February 27, 2024
Dr. Lee KY from the Department of Cardiology, Incheon St. Mary’s Hospital, The Catholic University of Korea, and co-authors from other Korean universities published in Nature Scientific Reports a comprehensive study involving 915 patients with angina and acute myocardial infarction (AMI), where QFR demonstrated high diagnostic accuracy, exceeding 95% for identifying fractional flow ratio (FFR) ≤ 0.8 in the angina group and 92% in the AMI group.
The study also highlighted the impact of conditions like tandem lesions on diagnostic accuracy. Despite these nuances, QFR showcased excellent correlation and agreement with FFR, making it a valuable tool for real-world patient assessments. Also, the diagnostic accuracy was reduced for tandem lesions (93.7%) vs non-tandem lesions (96.6%). The accuracies in the FFR border zone (0.75-0.85) were lower, where the hybrid approach would be considered. Further insights into patient characteristics, vessel specifics, and comparisons with other diagnostic methods enhance the understanding of QFR’s utility, reinforcing its role in guiding clinical decisions with efficiency and accuracy.
In conclusion, QFR showed excellent diagnostic performance in detecting functional ischemia, which was comparable to that of FFR in a real-world all-comer population cohort. The deferral based on negative QFR values could be as effective as the decision made by the FFR values in populations not only with stable angina but also with AMI.
