Coronary disease & ACSSecondary analysis
Quantitative Flow Ratio (QFR) Assessment and Prognosis After Nonculprit Percutaneous Coronary Intervention (PCI) in Patients With Acute Myocardial Infarction
- Secondary analysis of the FRAME-AMI randomised trial
- post hoc QFR analysis
Authors' conclusion
In AMI patients with multivessel disease, 30.0% of angiography-guided PCI resulted in un-necessary PCI for the non-IRA with QFR >0.80, which was significantly associated with an increased risk of MACEs than in those with deferred PCI for non-IRA lesions.
Study context
- Population
- Acute myocardial infarction (AMI) patients with multivessel disease in the FRAME-AMI trial (fractional flow reserve (FFR)-guided vs angiography-guided non-IRA PCI)
- Participants
- 443 patients · 552 lesions
- Comparison
- Non-IRA PCI despite QFR >0.80 vs deferred PCI for non-IRA lesions
- Primary endpoint
- Major adverse cardiac event (MACE):
- Cardiac death
- MI
- Repeat revascularization
- Follow-up
- Median 3.5 years
Primary result
MACE · median 3.5 years
Hazard ratio
4.13
95% CI 1.10–15.57
P = 0.036
By group
Non-IRA PCI despite QFR >0.80 vs Deferred PCI
HR 4.13 (95% CI 1.10–15.57); P = 0.036
As reported in the abstract
Further findings
| Outcome | Non-IRA PCI despite QFR >0.80 | Deferred PCI | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Non-IRA MACE · median 3.5 years | Not reported in the abstract | 2.1% | 5.44 (1.13–26.19) | P = 0.035 | |
| 0.050.21520Hazard ratio (log scale) |
- Non-IRA PCI despite QFR >0.80 (proportion): Angiography-guided PCI 30.0%
- Non-IRA PCI despite QFR >0.80 (proportion): FFR-guided PCI 2.7%
- Non-IRA PCI despite QFR >0.80 (proportion): 209 patients in each group
Original publication
QFR Assessment and Prognosis After Nonculprit PCI in Patients With Acute Myocardial Infarction. JACC Cardiovasc Interv. Published 9 October 2023. doi:10.1016/j.jcin.2023.08.032
Summarised from the published abstract; every number is checked against it