Fractional flow reserve (FFR) pullback reveals coronary artery disease patterns during catheterization lab work. Quantitative flow ratio (QFR) offers noninvasive FFR estimate from angiography alone. The study published in the International Journal of Cardiology checks if QFR patterns match plaque risks on optical coherence tomography (OCT) and predict events.
Objective Links QFR to OCT and Events
Researchers aimed to connect QFR-based disease patterns with OCT plaque features. They also tested ties to clinical outcomes in left anterior descending artery cases. Simple angiography tool could guide therapy without wires.
Methods Classify 216 Patients by QFR
They studied 216 patients with ≥25% stenosis in left anterior descending artery. QFR pullback used PPG index and dQFR/ds to sort into four groups. Group 1 had focal disease with major gradient. Group 2 showed focal without gradient. Group 3 had diffuse with gradient. Group 4 was diffuse without gradient. OCT assessed plaque types like lipids and thin-cap fibroatheromas.
Results Pinpoint High-Risk Group 3
Group 3 topped lipid-rich plaques (2.2 ± 1.1) and thin-cap fibroatheromas (1.3 ± 1.0), then Groups 1, 4, 2 (p=0.002, p=0.016). Groups 1 and 3 led lipid arc at peak dQFR/ds sites. Kaplan-Meier curves showed Group 3 worst outcomes. Multivariable analysis confirmed Group 3 (low PPG, high dQFR/ds) independently predicted events.
Conclusions Boost QFR in Daily Practice
QFR patterns mirror vulnerable plaques and prognosis. It flags high-risk CAD. Use it to tailor stents, medications, or multivessel plans.