Diagnostic Performance of Immediate Angiography Derived Quantitative Flow Ratio In Patients After Second Generation Drug Eluting Stent And Bioresorable Scaffold Implantation

Abstract

\n Quantitative flow ratio (QFR) is a novel angiography derived fractional flow reserve (FFR). However, its diagnostic performance has only be validated in native coronary lesion but not yet in vessels after stent implantation. This study aims to evaluate the diagnostic performance of QFR in coronary vessels immediately after everolimus eluting stent (EES) and bioresorbable scaffold (BRS) implantation. This is a retrospective, two centers, validation cohort study. 73 stable angina patients who received at least one native vessel EES/BRS implantation with immediate FFR assessment were screened. Cases with aorta-ostial stenoses, bridge vessel at the distal of targated vessel, acute coronary syndrome, previous coronary artery bypass grafting, age\u2009<\u200918 years, lack of ≥\u20092 final angiographic projections were excluded. Contrast QFR assessment was performed blinded to FFR assessment. A good correlation (r\u2009=\u20090.680, p\u2009<\u20090.001) was found between QFR and FFR. In the EES implantation cohort, a good correlation (r\u2009=\u20090.769, p\u2009<\u20090.001) was found between QFR and FFR, while moderate correlation (r\u2009=\u20090.446, p\u2009=\u20090.038) was found in the BRS cohort. The area under the ROC curve for detecting FFR\u2009≤\u20090.86 was 0.883 for the total subjects. QFR assessment after immediate EES/BRS implantation is feasible, and remains good correlation and agreement with FFR. QFR might be a promising tool for guiding stent implantation optimizing to improve clinical outcomes.