Clinical Evidence

Christiaan Vrints, Felicita Andreotti, Konstantinos C. Koskinas, Xavier Rossello, Marianna Adamo, James Ainslie, Adrian Paul Banning, Andrzej Budaj, Ronny R. Buechel, Giovanni Alfonso Chiariello, Alaide Chieffo, Ruxandra Maria Christodorescu, Christi Deaton, Torsten Doenst, Hywel W. Jones, Vijay Kunadian, Julinda Mehilli, Milan Milojevic, Jan J. Piek, Francesca Pugliese, Andrea Rubboli, Anne Grete Semb, Roxy Senior, Jurrien M. ten Berg, Eric Van Belle, Emeline M. Van Craenenbroeck, Rafael Vidal-Perez, Simon Winther, and ESC Scientific Document Group

The 2024 ESC guidelines have introduced important updates for Medis QFR®, highlighting its role in three key areas of cardiac care. First, Medis QFR® received a Class IB recommendation for assessing epicardial artery stenosis. This technology, which utilizes 3D QCA and flow velocity, provides a clear advantage over angiography-based FFR methods, which only have a Class IIb/C recommendation. Studies confirm that using QFR® to guide interventions reduces the rates of myocardial infarctions and ischemia-driven revascularizations, demonstrating that this method is more effective than visual assessments of angiograms. Medis QFR® is designed for both prospective/immediate and retrospective data analysis, offering a comprehensive physiology platform.

Second, Medis QFR® now has a Class IA recommendation for selecting lesions in patients with multivessel disease, enabling detailed examinations of multiple vessels and lesions using only angiograms. This approach helps reduce the risks associated with inserting pressure wires and cuts down on costs.

Additionally, for managing chronic coronary syndrome in patients with chronic heart failure, Medis QFR® is recommended with a Class IC for those with a left ventricular ejection fraction over 35% and a high likelihood of obstructive coronary artery disease. The guidelines also highlight the expanded understanding of coronary syndromes, recognizing the significance of both macrovascular and microvascular abnormalities that can lead to myocardial ischemia. Notably, Medis QFR® integrates features like the angiography-derived index of coronary microcirculatory resistance (angio-IMR), which assesses microcirculation without the need for intracoronary wires, offered via QFR-IMR®.