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Purpose <p>The association between the intra-procedure quantitative flow ratio (QFR) and clinical outcomes after drug-coated balloon (DCB) angioplasty has not been investigated. This study aimed to investigate the clinical predictive value of pre-DCB QFR, a functional assessment of lesion preparation, for clinical outcomes in de novo coronary lesions after DCB angioplasty.</p> Methods <p>This retrospective study included 170 consecutive patients undergoing DCB angioplasty for 177 de novo coronary lesions between January 2021 and December 2022. The QFR was computed at baseline, pre-DCB, and post-DCB. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause death, cardiac death, target vessel myocardial infarction, and target lesion revascularization.</p> Results <p>During 2-year follow-up, 37 patients with 38 lesions have experienced MACE. The pre-DCB QFR, measured after pre-dilation, was significantly lower in the MACE group. Receiver operator characteristic curve analysis showed the optimal pre-DCB QFR cut-off value for predicting MACE was 0.925 (area under curve = 0.782, 95% confidence interval [CI] 0.702–0.861, sensitivity = 78.9%, specificity = 74.8%, <i>p</i> &lt; 0.001). A pre-DCB QFR &lt; 0.925 was associated with a significantly higher risk of MACE compared with a value &gt; 0.925 (46.1% vs. 7.1%, <i>p</i> &lt; 0.001). In multivariable Cox regression analyses, pre-DCB QFR &lt; 0.925 was associated with an over sixfold increased risk of MACE (hazard ratio = 7.483, 95% CI 3.363–16.653, <i>p</i> &lt; 0.001).</p> Conclusion <p>The pre-DCB QFR was a promising predictor of unfavorable clinical outcomes in de novo coronary lesions after DCB angioplasty.</p>

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Clinical Implication of Quantitative Flow Ratio to Predict Clinical Outcomes in De Novo Coronary Lesions After Drug-Coated Balloon Angioplasty

  • 期刊论文

  • 发表日期：

    2025年6月20日

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  • Feng Liu,
  • Haipeng Cai

摘要

Purpose

The association between the intra-procedure quantitative flow ratio (QFR) and clinical outcomes after drug-coated balloon (DCB) angioplasty has not been investigated. This study aimed to investigate the clinical predictive value of pre-DCB QFR, a functional assessment of lesion preparation, for clinical outcomes in de novo coronary lesions after DCB angioplasty.

Methods

This retrospective study included 170 consecutive patients undergoing DCB angioplasty for 177 de novo coronary lesions between January 2021 and December 2022. The QFR was computed at baseline, pre-DCB, and post-DCB. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause death, cardiac death, target vessel myocardial infarction, and target lesion revascularization.

Results

During 2-year follow-up, 37 patients with 38 lesions have experienced MACE. The pre-DCB QFR, measured after pre-dilation, was significantly lower in the MACE group. Receiver operator characteristic curve analysis showed the optimal pre-DCB QFR cut-off value for predicting MACE was 0.925 (area under curve = 0.782, 95% confidence interval [CI] 0.702–0.861, sensitivity = 78.9%, specificity = 74.8%, p < 0.001). A pre-DCB QFR < 0.925 was associated with a significantly higher risk of MACE compared with a value > 0.925 (46.1% vs. 7.1%, p < 0.001). In multivariable Cox regression analyses, pre-DCB QFR < 0.925 was associated with an over sixfold increased risk of MACE (hazard ratio = 7.483, 95% CI 3.363–16.653, p < 0.001).

Conclusion

The pre-DCB QFR was a promising predictor of unfavorable clinical outcomes in de novo coronary lesions after DCB angioplasty.