Post-PCI μQFR distributions were similar between treatment groups, but lower values were associated with higher 5-year adverse event risk without significant treatment interaction, and limited binary discrimination supports use as a continuous metric for post-PCI physiological risk stratification.
Post-PCI μQFR was successfully analysed in most of the study population, with similar distributions between randomised treatment groups.
Lower post-PCI μQFR tertiles were associated with a higher 5-year incidence of MACE.
After adjustment, the lowest μQFR tertile had significantly higher MACE risk than the highest tertile, while the intermediate tertile did not.
A ROC-derived cutoff of post-PCI μQFR <0.94 identified patients with higher MACE rates.
No significant interaction was found between treatment strategy and post-PCI μQFR in relation to outcomes.
The authors conclude that limited binary discrimination supports using post-PCI μQFR as a continuous metric for risk stratification.
This study looked at whether a measurement of blood flow in heart arteries taken right after a stent procedure (PCI) can predict later heart problems. The measurement, called μQFR, is calculated by computer from a single angiogram image, without inserting a pressure wire. The researchers analysed 4,196 treated vessels from 3,455 patients in the FAVOR III China trial and followed them for five years. Patients whose post-procedure μQFR was lowest had more major adverse events (death, heart attack, or repeat revascularisation for ischaemia) over five years: 23.1% in the lowest group versus 17.2% in the highest. After adjusting for other factors, the lowest group had about a 30% higher relative risk. A single cutoff of 0.94 also separated higher-risk from lower-risk patients (22.3% vs 17.4%), but the separation was modest. The relationship did not differ significantly by which treatment strategy patients had been randomised to. This research suggests that μQFR after stenting may help gauge a patient's later risk, with lower values signalling higher risk. Because a single cutoff did not discriminate strongly, the authors suggest the value is better viewed as a continuous scale than a pass/fail test. This was a subgroup analysis of a trial, so it shows association rather than proving that acting on the value would improve outcomes.
Zhang R, Xu J, Guan C, Jiang Y, Shi Y, Tu S, et al.. (2026). Prognostic value of Murray law-based quantitative flow ratio after percutaneous coronary intervention.. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. https://doi.org/10.4244/EIJ-D-26-00457