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Serial changes in the quantitative flow ratio in patients with intermediate residual stenosis after percutaneous coronary intervention

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Abstract

A beneficial surrogate marker for evaluating the effect of medical therapy is warranted to avoid deferred lesion revascularization. Similar to coronary artery imaging for monitoring the effects of medical therapy by analyzing plaque regression and stabilization, we hypothesized that evaluation of serial changes in the quantitative flow ratio (QFR) would serve as a surrogate marker of the effects of medical therapy against deferred lesion revascularization. Here, we investigated serial changes in QFR over time after percutaneous coronary intervention in patients who underwent medical therapy as a secondary prevention. Patients with intermediate stenosis in an untreated vessel observed at the baseline (BL) coronary angiography and follow-up (FU) coronary angiography performed 6–18 months after BL angiography were screened in 2 centers. A total of 52 patients were able to analyze both BL and FU QFR. The median QFR was 0.83 (IQR, 0.69, 0.89) at BL and 0.80 (IQR, 0.70, 0.86) at FU. The number of positive ΔQFR and negative ΔQFR were 21 and 31, respectively. The median ΔQFR was 0.05 (IQR, 0.03, 0.09) in positive ΔQFR and  – 0.05 (IQR,  – 0.07,  – 0.03) in negative ΔQFR (p < 0.0001). Univariate and multivariate analyses revealed that LDL-C at FU predicted improvement in the QFR (OR 0.95, 95% confidence interval [0.91, 0.98], P = 0.001). Assessment of serial changes in the QFR may serve as a surrogate marker for the effects of medical therapy in patients with residual intermediate coronary stenosis.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan

    Hitoshi Takenaka, Takayuki Okamura, Yosuke Miyazaki, Tatsuhiro Fujimura, Hiroki Tateishi, Mamoru Mochizuki, Hideaki Akase, Takeshi Suetomi, Hitoshi Uchinoumi, Tetsuro Oda & Masafumi Yano

  2. Department of Clinical Engineering, Yamaguchi University Hospital, Ube, Japan

    Akinori Ono

  3. Department of Cardiology, Hagi Civil Hospital, Hagi, Japan

    Takeshi Nakamura

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  1. Hitoshi Takenaka
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  2. Takayuki Okamura
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Correspondence to Takayuki Okamura.

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This study was supported by JSPS KAKENHI Grant Number JP17K09504.

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Takenaka, H., Okamura, T., Miyazaki, Y. et al. Serial changes in the quantitative flow ratio in patients with intermediate residual stenosis after percutaneous coronary intervention. Heart Vessels 37, 363–373 (2022). https://doi.org/10.1007/s00380-021-01923-x

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