Prognostic value of Murray law-based quantitative flow ratio after percutaneous coronary intervention.
Rui Zhang, Jingjing Xu, Changdong Guan et al.
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In 30 seconds
This prespecified subgroup analysis of the randomised FAVOR III China trial assessed whether post-PCI Murray law-based quantitative flow ratio (μQFR) was associated with long-term outcomes. Offline μQFR was analysed in 4,196 vessels from 3,455 patients, and the primary outcome was 5-year major adverse cardiovascular events (MACE). MACE incidence was higher across descending μQFR tertiles: 23.1% vs 19.0% vs 17.2% (p=0.001). Compared with μQFR>0.95, the lowest tertile (μQFR ≤0.91) was associated with higher adjusted risk (aHR 1.30, 95% CI: 1.06-1.60).
Key findings
- Five-year MACE incidence was 23.1% vs 19.0% vs 17.2% across low, intermediate, and high post-PCI μQFR tertiles (p=0.001).
- Compared with μQFR>0.95, the lowest tertile (μQFR ≤0.91) had higher adjusted MACE risk: aHR 1.30 (95% CI: 1.06-1.60).
- MACE occurred in 22.3% with μQFR <0.94 versus 17.4% with μQFR ≥0.94 (aHR 1.23, 95% CI: 1.04-1.47; p=0.02).
- There was no significant interaction between treatment strategy and post-PCI μQFR (p for interaction=0.23).
Why it matters
The findings support an association between lower post-PCI μQFR and greater long-term cardiovascular risk, suggesting that physiological assessment after PCI may help stratify prognosis. The authors note that binary discrimination is limited and favour interpreting μQFR as a continuous risk measure rather than relying solely on a cutoff.
What to keep in mind
This was a prespecified subgroup analysis with offline μQFR assessment in eligible PCI-treated vessels; the reported associations do not establish that μQFR-guided management improves outcomes.