Coronary disease & ACS

Quantitative Flow Ratio (QFR) for the Revascularization of Nonculprit Vessels in Myocardial Infarction (MI) Patients: Insights From the FIRE Trial

JACC Cardiovasc IntervPublished Secondary analysis of the FIRE randomised trial

Authors' conclusion

This prespecified subanalysis of the FIRE trial provides evidence supporting the safety and efficacy of QFR-guided interventions for the treatment of nonculprit vessels in MI patients.

Study context

Population
Older MI patients with multivessel disease903 vessels, 685 patients with QFR
Participants
1,445 patients
Comparison
QFR ≤0.80 vs QFR >0.80 in nonculprit vessels (culprit-only arm); QFR-guided vs wire-based functional assessment-guided revascularization (complete arm)
  • QFR ≤0.80n = 366
  • QFR-guidedn = 320
Primary endpoint
Vessel-oriented composite endpoint (VOCE)
Follow-up
1 year
Methodological detailsprespecified subanalysis, propensity-matched
  • Prespecified subanalysis
  • Propensity-matched

Primary result

As reported in the abstract

VOCE
Hazard ratio (95% CI)P value
QFR ≤0.80 vs QFR >0.80independent predictor; P for incidence comparison
2.79(1.64–4.75)
P < 0.001
QFR-guided vs Wire-basedno significant difference; propensity-matched
0.57(0.28–1.15)

Original publication

QFR for the Revascularization of Nonculprit Vessels in MI Patients: Insights From the FIRE Trial. JACC Cardiovasc Interv. Published 14 May 2024. doi:10.1016/j.jcin.2024.04.022

Summarised from the published abstract; every number is checked against it

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