Prognostic value of QFR directly after successful PCI

Prognostic value of QFR directly after successful PCI

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.

For further read: Prognostic Value of QFR Measured Immediately After Successful Stent Implantation

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