Evidence map›Paper›PMID 40025631›Full record

Trial reportChinese medical journal2025

Cost-effectiveness of angiographic quantitative flow ratio-guided coronary intervention: A multicenter, randomized, sham-controlled trial.

Yanyan Zhao, Changdong Guan, Yang Wang, Zening Jin, Bo Yu, Guosheng Fu, Yundai Chen, Lijun Guo, Xinkai Qu, Yaojun Zhang and 12 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Chinese medical journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03656848 (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous InterVention in Patients With cORonary Artery Disease), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT03656848 naunknown statusnot on this map

Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous InterVention in Patients With cORonary Artery Disease (The FAVOR III China Study)

TypeinterventionalSponsorChina National Center for Cardiovascular DiseasesRan2018 to 2025Enrolled3,847ConditionsCoronary Artery Disease, Myocardial Ischaemia, Coronary Circulation, Coronary StenosisArmsQFR, Angiography
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

22 authors.

Yanyan ZhaoMedical Research and Biometrics Center, National Center for Cardiovascular Diseases, Beijing 100037, China.
Changdong GuanDepartment of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Yang WangMedical Research and Biometrics Center, National Center for Cardiovascular Diseases, Beijing 100037, China.
Zening JinDepartment of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
Bo YuDepartment of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, China.
Guosheng FuDepartment of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, China.
Yundai ChenDepartment of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China.
Lijun GuoDepartment of Cardiology, Peking University Third Hospital, Beijing 100191, China.
Xinkai QuDepartment of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China.
Yaojun ZhangDepartment of Cardiology, Xuzhou Third People's Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221005, China.
Kefei DouDepartment of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Yongjian WuDepartment of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Weixian YangDepartment of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Shengxian TuBiomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200025, China.
Javier EscanedHospital Clínico San Carlos IDISSC, Complutense University of Madrid, Madrid 28040, Spain.
William F FearonDivision of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University School of Medicine and VA Palo Alto Health Care System, Palo Alto, CA 94305, USA.
Shubin QiaoDepartment of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
David J CohenCardiovascular Research Foundation, New York, NY 10019, USA.
Harlan M KrumholzSection of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT 06510, USA.
Bo XuDepartment of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Lei SongDepartment of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
FAVOR III China Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe FAVOR (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients with Coronary Artery Disease) III China trial demonstrated that percutaneous coronary intervention (PCI) lesion selection using quantitative flow ratio (QFR) measurement, a novel angiography-based approach for estimating fractional flow reserve, improved two-year clinical outcomes compared with standard angiography guidance. This study aimed to assess the cost-effectiveness of QFR-guided PCI from the perspective of the current Chinese healthcare system.

methodsThis study is a pre-specified analysis of the FAVOR III China trial, which included 3825 patients randomized between December 25, 2018, and January 19, 2020, from 26 centers in China. Patients with stable or unstable angina pectoris or those ≥72 hours post-myocardial infarction who had at least one lesion with a diameter stenosis between 50% and 90% in a coronary artery with a ≥2.5 mm reference vessel diameter by visual assessment were randomized to a QFR-guided strategy or an angiography-guided strategy with 1:1 ratio. During the two-year follow-up, data were collected on clinical outcomes, quality-adjusted life-years (QALYs), estimated costs of index procedure hospitalization, outpatient cardiovascular medication use, and rehospitalization due to major adverse cardiac and cerebrovascular events (MACCE). The primary analysis calculated the incremental cost-effectiveness ratio (ICER) as the cost per MACCE avoided. An ICER of ¥10,000/MACCE event avoided was considered economically attractive in China.

resultsAt two years, the QFR-guided group demonstrated a reduced rate of MACCE compared to the angiography-guided group (10.8% vs . 14.7%, P <0.01). Total two-year costs were similar between the groups (¥50,803 ± 21,121 vs . ¥50,685 ± 23,495, P = 0.87). The ICER for the QFR-guided strategy was ¥3055 per MACCE avoided, and the probability of QFR being economically attractive was 64% at a willingness-to-pay threshold of ¥10,000/MACCE avoided. Sensitivity analysis showed that QFR-guided PCI would become cost-saving if the cost of QFR were below ¥3682 (current cost: ¥3800). Cost-utility analysis yielded an ICER of ¥56,163 per QALY gained, with a 53% probability of being cost-effective at a willingness-to-pay threshold of ¥85,000 per QALY gained.

conclusionIn patients undergoing PCI, a QFR-guided strategy appears economically attractive compared to angiographic guidance from the perspective of the Chinese healthcare system.

trial registrationClinicalTrials.gov , NCT03656848.

Indexed as

Coronary AngiographyCost-Benefit AnalysisPercutaneous Coronary InterventionAgedCoronary Artery DiseaseFemaleFractional Flow Reserve, MyocardialHumansMaleMiddle AgedQuality-Adjusted Life YearsCoronary artery diseaseEuropean Quality of Life-5 DimensionsIncremental cost-effectiveness ratioMajor adverse cardiac and cerebrovascular eventsPercutaneous coronary interventionQuality-adjusted life-yearsQuantitative flow ratio

Identifiers

PMID40025631
PMCPMC12091619

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.