ArticleClinical research in cardiology : official journal of the German Cardiac Society2021
Quantitative flow ratio (QFR) identifies functional relevance of non-culprit lesions in coronary angiographies of patients with acute myocardial infarction.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Comparison of Coronary Angiographic-Derived and Intracoronary Imaging-Based Fractional Flow Reserve in Assessing Coronary Artery Stenosis Severity: A Systematic Review and Network Meta-Analysis.Journal of evidence-based medicine · 2025Pooled it
- Quantitative flow ratio or angiography for the assessment of non-culprit lesions in acute coronary syndromes, a randomized trial.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Trial
- Optimal revascularization strategy in patients with acute coronary syndrome and multivessel disease: insights from a network meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Impact of low-density lipoprotein cholesterol-lowering therapy on intermediate stenosis in non-culprit vessels of acute coronary syndrome.BMC cardiovascular disorders · 2025Article
- From Evidence to Practice: The Growing Role of Angiography-Derived Physiology.Journal of clinical medicine · 2025Review
- Article
- Association between residual cholesterol and vulnerable non-culprit lesions progressing to major adverse cardiovascular events.Frontiers in endocrinology · 2025Observational
- Enhancing cardiac assessments: accurate and efficient prediction of quantitative fractional flow reserve.Frontiers in bioengineering and biotechnology · 2025Article
- The association between cardiac T2*BOLD and quantitative flow ratio (QFR) in the diagnosis of stenotic coronary arteries in patients with multi-vessel coronary artery disease.La Radiologia medica · 2024Article
- Effects of coronary artery disease in patients with permanent left bundle branch area pacing: A retrospective study.Heliyon · 2024Article
- Practical Application of Coronary Physiologic Assessment: Asia-Pacific Expert Consensus Document: Part 1.JACC. Asia · 2023Review
- Angiographic quantitative flow ratio in acute coronary syndrome: beyond a tool to define ischemia-causing stenosis-a literature review.Cardiovascular diagnosis and therapy · 2022Review
- Quantitative Flow Ratio Is Related to Anatomic Left Main Stem Lesion Parameters as Assessed by Intravascular Imaging.Journal of clinical medicine · 2022Article
- Diagnostic efficacy of serum ST2 in patients with ASC.Journal of clinical laboratory analysis · 2022Article
- Angiography-Based Fractional Flow Reserve: State of the Art.Current cardiology reports · 2022Review
- Quantitative Flow Ratio or Angiography for the Assessment of Non-culprit Lesions in Acute Coronary Syndromes: Protocol of the Randomized Trial QUOMODO.Frontiers in cardiovascular medicine · 2022Article
- Quantitative Flow Ratio Is Associated with Extent and Severity of Ischemia in Non-Culprit Lesions of Patients with Myocardial Infarction.Journal of clinical medicine · 2021Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn patients with acute myocardial infarction (AMI) and multivessel coronary disease, revascularization of non-culprit lesions guided by proof of ischemia usually requires staged ischemia testing. Quantitative flow ratio (QFR) has been shown to be effective in assessing the hemodynamic relevance of lesions in stable coronary disease. However, its suitability in AMI patients is unknown. In this study, we tested the diagnostic value of QFR based on acute angiograms (aQFR) during AMI to assess the hemodynamic relevance of non-culprit lesions.
methodsWe retrospectively assessed the diagnostic efficiency of aQFR in 280 vessels from 220 patients, comparing it with staged ischemia testing using elective coronary angiography with FFR (n = 47), stress cardiac MRI (n = 200) or SPECT (n = 33).
resultsaQFR showed a very good diagnostic efficiency (AUC = 0.887, 95% CI 0.832-0.943, p < 0.001) in predicting ischemia of non-culprit lesions, significantly superior to coronary lesion's geometry as assessed by quantitative coronary angiography. The optimal cut-off for aQFR to predict ischemia was 0.80 (sensitivity = 83.7%, specificity = 86.1%). Maintaining a predefined level of 95% sensitivity and specificity, we created a decision model based on aQFR: lesions with aQFR ≤ 0.75 should be treated, lesions with aQFR ≥ 0.92 do not yield any hemodynamic relevance, and lesions in the "grey zone" (aQFR 0.75-0.92) benefit from further ischemia testings. This model would allow to reduce staged ischemia tests by 46.8% without a relevant loss in diagnostic efficiency.
conclusionOur data demonstrate that aQFR allows an effective assessment of hemodynamic relevance of non-culprit lesions in AMI and may guide interventions of non-culprit coronary lesions.
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