Recently Dr Simone Biscaglia and colleagues of the team of Prof Gianluca Campo published this very important paper in JACC interventions. A total of 751 vessels in 602 patients were analyzed and the median QFR value post-PCI was 0.97. The primary outcome was the vessel-oriented composite endpoint. Altogether, a total of 77 events were detected in 53 treated vessels (7%). After correction for potential confounding factors, post-PCI <=0.89 was associated with a 3-fold increase in risk for the vessel-oriented composite endpoint.
Their conclusion was: Lower values of QFR after complete and successful revascularization predict subsequent adverse events.
Was the ball inside or outside the Court? Ask the Hawk-Eye System.
Prof Serruys, Dr Kogame and Dr Onuma wrote a very nice Editorial Comment to the Hawkeye publication. They stressed the importance of Post-PCI physiological assessment for 2 main reasons: 1) it can be used for stent optimization; and 2) it can be used as a predictor of long-term clinical outcomes. Furthermore, to their knowledge, the HAWKEYE trial is the first to prospectively investigate the relationship between post-PCI QFR value and clinical outcomes. A few propositions were also made: post-PCI QFR needs to be further validated against post-PCI FFR; and further automate the QFR software and refinement of the measurement methodology. And furthermore, more confirmatory data is needed, but for the time being the post-PCI threshold of 0.89 is a very interesting value for the arbiter.
For further read: JACC Interventions 2019