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. 2025 Jun 20.
doi: 10.1007/s10557-025-07735-9. Online ahead of print.

Clinical Implication of Quantitative Flow Ratio to Predict Clinical Outcomes in De Novo Coronary Lesions After Drug-Coated Balloon Angioplasty

Feng Liu  1 , Haipeng Cai  2
Affiliations

Clinical Implication of Quantitative Flow Ratio to Predict Clinical Outcomes in De Novo Coronary Lesions After Drug-Coated Balloon Angioplasty

Feng Liu et al. Cardiovasc Drugs Ther. .

Abstract

Purpose: The association between the intra-procedure quantitative flow ratio (QFR) and clinical outcomes after drug-coated balloon (DCB) angioplasty has not been investigated. This study aimed to investigate the clinical predictive value of pre-DCB QFR, a functional assessment of lesion preparation, for clinical outcomes in de novo coronary lesions after DCB angioplasty.

Methods: This retrospective study included 170 consecutive patients undergoing DCB angioplasty for 177 de novo coronary lesions between January 2021 and December 2022. The QFR was computed at baseline, pre-DCB, and post-DCB. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause death, cardiac death, target vessel myocardial infarction, and target lesion revascularization.

Results: During 2-year follow-up, 37 patients with 38 lesions have experienced MACE. The pre-DCB QFR, measured after pre-dilation, was significantly lower in the MACE group. Receiver operator characteristic curve analysis showed the optimal pre-DCB QFR cut-off value for predicting MACE was 0.925 (area under curve = 0.782, 95% confidence interval [CI] 0.702-0.861, sensitivity = 78.9%, specificity = 74.8%, p < 0.001). A pre-DCB QFR < 0.925 was associated with a significantly higher risk of MACE compared with a value > 0.925 (46.1% vs. 7.1%, p < 0.001). In multivariable Cox regression analyses, pre-DCB QFR < 0.925 was associated with an over sixfold increased risk of MACE (hazard ratio = 7.483, 95% CI 3.363-16.653, p < 0.001).

Conclusion: The pre-DCB QFR was a promising predictor of unfavorable clinical outcomes in de novo coronary lesions after DCB angioplasty.

Keywords: De novo coronary lesion; Drug-coated balloon; Major adverse cardiac events; Quantitative flow ratio.

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Conflict of interest statement

Declarations. Ethics Approval: This study complied with the Declaration of Helsinki and was approved by Taizhou Central Hospital Review Board. Consent to Participate: Written informed consent was obtained from all patients before cardiac catheterization. Consent for Publication: All authors read and approved the final version of manuscript for publication. Competing interests: The authors declare no competing interests.

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References

    1. Nakazawa G, Otsuka F, Nakano M, Vorpahl M, Yazdani SK, Ladich E, Kolodgie FD, Finn AV, Virmani R. The pathology of neoatherosclerosis in human coronary implants bare-metal and drug-eluting stents. J Am Coll Cardiol. 2011;57:1314–22. https://doi.org/10.1016/j.jacc.2011.01.011 . - DOI - PubMed - PMC
    1. Hassan AK, Bergheanu SC, Stijnen T, van der Hoeven BL, Snoep JD, Plevier JW, Schalij MJ, Wouter JJ. Late stent malapposition risk is higher after drug-eluting stent compared with bare-metal stent implantation and associates with late stent thrombosis. Eur Heart J. 2010;31:1172–80. https://doi.org/10.1093/eurheartj/ehn553 . - DOI - PubMed
    1. Jeger RV, Eccleshall S, Wan Ahmad WA, Ge J, Poerner TC, Shin ES, Alfonso F, Latib A, Ong PJ, Rissanen TT, et al. Drug-coated balloons for coronary artery disease: Third Report of the International DCB Consensus Group. JACC Cardiovasc Interv. 2020;13:1391–402. https://doi.org/10.1016/j.jcin.2020.02.043 . - DOI - PubMed
    1. Vrints C, Andreotti F, Koskinas KC, Rossello X, Adamo M, Ainslie J, Banning AP, Budaj A, Buechel RR, Chiariello GA, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024;45:3415–537. https://doi.org/10.1093/eurheartj/ehae177 . - DOI - PubMed
    1. Ma Z, Liu K, Hu Y, Hu X, Wang B, Li Z. Comparison between drug-coated balloon and stents in large de novo coronary artery disease: a systematic review and meta-analysis of RCT data. Cardiovasc Drugs Ther. 2024. https://doi.org/10.1007/s10557-024-07548-2 . - DOI - PubMed - PMC

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