Prognostic implications of increased and final quantitative flow ratios in patients treated with drug-coated balloons physiological evaluation after DCB in de novo lesions.

BACKGROUND

Few studies investigated the implications of post-PCI QFR and post-PCI ΔQFR (absolute increase of QFR) in de novo lesions of small coronary disease after drug-coated balloon (DCB).

OBJECTIVES

We sought to investigate the prognostic implications of post-PCI QFR and post-PCI ΔQFR in patients who received DCB only.

METHODS

Patients were divided according to the optimal cutoff value of the post-PCI QFR and the post-PCI ΔQFR. The primary outcome was major adverse cardiovascular events (MACE), including target vessel revascularization (TVR), cardiac death, and myocardial infarction (MI).

RESULTS

The optimal cutoff values of QFR and ΔQFR for the MACE rate were 0.86 and 0.57, respectively. There were 175 patients (61.2%) with a high QFR (≥ 0.86) and 113 patients (39.5%) with a high ΔQFR (≥ 0.57) after PCI. The MACE rate was significantly higher in patients with a low QFR compared to a high QFR (5.7% vs. 27.0%, hazard ratio [HR]: 3.632, 95% confidence interval [CI]: 1.872 to 7.044, P < 0.001). The MACE rate was higher in patients with a low ΔQFR increase compared to those with high ΔQFR (4.4% vs. 20.2%, HR: 4.700, 95%CI: 2.430 to 9.089, P = 0.001). In multivariable model, a low post-PCI QFR and a low post-PCI ΔQFR was independent predictor of MACE (adjusted HR: 4.071, 95%CI: 2.037 to 8.135, P = 0.001).

CONCLUSIONS

After DCB in de novo lesions of small coronary disease, both post-PCI QFR and ΔQFR showed similar prognostic implications in MACE.