Evidence map›Paper›PMID 38174345›Full record

ArticleEuropean heart journal open2024

Prognostic role of discordance between quantitative flow ratio and visual estimation in revascularization guidance.

Dimitrios Terentes-Printzios, Dimitrios Oikonomou, Konstantia-Paraskevi Gkini, Vasiliki Gardikioti, Konstantinos Aznaouridis, Ioanna Dima, Konstantinos Tsioufis, Charalambos Vlachopoulos

Abstract read
In one paragraph

Article in European heart journal open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Dimitrios Terentes-PrintziosFirst Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration Hospital, 114 Vassilisis Sofias St, 11527 Athens, Greece.ORCID https://orcid.org/0000-0003-4039-8263
Dimitrios OikonomouFirst Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration Hospital, 114 Vassilisis Sofias St, 11527 Athens, Greece.ORCID https://orcid.org/0000-0001-9722-5297
Konstantia-Paraskevi GkiniFirst Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration Hospital, 114 Vassilisis Sofias St, 11527 Athens, Greece.
Vasiliki GardikiotiFirst Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration Hospital, 114 Vassilisis Sofias St, 11527 Athens, Greece.
Konstantinos AznaouridisFirst Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration Hospital, 114 Vassilisis Sofias St, 11527 Athens, Greece.ORCID https://orcid.org/0000-0002-0706-4424
Ioanna DimaFirst Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration Hospital, 114 Vassilisis Sofias St, 11527 Athens, Greece.
Konstantinos TsioufisFirst Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration Hospital, 114 Vassilisis Sofias St, 11527 Athens, Greece.
Charalambos VlachopoulosFirst Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration Hospital, 114 Vassilisis Sofias St, 11527 Athens, Greece.ORCID https://orcid.org/0000-0002-9904-3558

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Revascularization guided by functional severity has presented improved outcomes compared with visual angiographic guidance. Quantitative flow ratio (QFR) is a reliable angiography-based method for functional assessment. We sought to investigate the prognostic value of discordance between QFR and visual estimation in coronary revascularization guidance. Methods and results: We performed offline QFR analysis on all-comers undergoing coronary angiography. Vessels with calculated QFR were divided into four groups based on the decision to perform or defer percutaneous coronary intervention (PCI) and on the QFR result, i.e.: Group A (PCI-, QFR > 0.8); Group B (PCI+, QFR ≤ 0.8); Group C (PCI+, QFR > 0.8); Group D (PCI-, QFR ≤ 0.8). Patients with at least one vessel falling within the disagreement groups formed the discordance group, whereas the remaining patients formed the concordance group. The primary endpoint was the composite endpoint of cardiovascular death, myocardial infarction, and ischaemia-driven revascularization. Overall, 546 patients were included in the study. Discordance between QFR and visual estimation was found in 26.2% of patients. After a median follow-up period of 2.5 years, the discordance group had a significantly higher rate of the composite outcome (hazard ratio: 3.34, 95% confidence interval 1.99-5.60, Conclusion: Discordance between QFR and visual estimation in revascularization guidance was associated with a worse long-term prognosis. Our results highlight the importance of proper patient selection for intervention and the need to avoid improper stent implantations when not dictated by a comprehensive functional assessment.

Indexed as

Coronary angiographyFractional flow reservePercutaneous coronary interventionPrognosisQuantitative flow ratio

Identifiers

PMID38174345
PMCPMC10763540

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