Trial reportEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2026
Repeatability and quality assessment of QFR in the FAVOR III Europe trial: the REPEAT-QFR study.
Trial report in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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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.
Who cites it
8 citing papers in PubMed.
- Quantitative flow ratio versus fractional flow reserve: 2-year follow-up of the FAVOR III Europe trial.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2026Trial
- Computational wireless indices for the assessment of myocardial ischaemia.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2026Review
- The Contemporary Role of Intracoronary Physiological Assessment: Fractional Flow Reserve, Non-Hyperemic Pressure Ratios, Wireless Technologies, and Microcirculation.Journal of cardiovascular development and disease · 2026Review
- From Electrocardiography to the Catheterization Laboratory: A Multimodal Artificial Intelligence Framework for Acute Coronary Syndrome Detection and Risk Stratification.Diagnostics (Basel, Switzerland) · 2026Review
- Expanding physiology beyond the wire: will 2026 be the defining year?EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2026Article
- Right Tool for Right Lesion: Moving Toward Lesion-Specific Imaging-Integrated Coronary Physiology.JACC. Asia · 2026Article
- QFR in clinical practice: raising the bar for quality and reproducibility.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2026Article
- Ultrasonic flow ratio versus Murray law-based quantitative flow ratio for predicting target vessel failure after IVUS-guided PCI.Frontiers in cardiovascular medicine · 2026Article
Corrections and comments
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundQuantitative flow ratio (QFR) is a guideline-recommended angiography-based estimation of fractional flow reserve (FFR) for functional lesion evaluation. The FAVOR III Europe trial raised concerns regarding the safety and efficacy of QFR compared with FFR. Whether the poor clinical outcomes in the trial were attributable to software limitations or suboptimal in-procedure QFR analysis is unknown.
aimsWe aimed to compare in-procedure and core laboratory QFR, and to evaluate the quality of in-procedure QFR analyses.
methodsThe 1,008 patients randomised to QFR in FAVOR III Europe were assessed for eligibility. Core laboratory QFR analyses were performed by two blinded observers. The quality of in-procedure QFR analyses were evaluated during patient enrolment. Quality scores from 1 (very poor) to 5 (very good) were assigned based on adherence to the standard operating procedure (SOP).
resultsOf 1,233 vessels with in-procedure QFR, 1,191 (96.6%) were analysable in the core laboratory and were included in the paired analysis. The median in-procedure QFR was 0.81 (interquartile range [IQR] 0.71-0.90) and core laboratory QFR was 0.84 (IQR 0.73-0.91). The mean difference was 0.02 (95% limits of agreement: -0.26 to 0.29). Spearman's rank correlation coefficient was 0.58, and diagnostic agreement was 72%. Most in-procedure QFR analyses demonstrated very good (19%), good (45%), or acceptable (28%) SOP adherence, while 8% were rated as poor or very poor. Suboptimal angiographic quality, poor in-procedure QFR analysis quality, high SYNTAX score, and diabetes were predictors of increased variability.
conclusionsIn FAVOR III Europe, agreement between in-procedure and core laboratory QFR was modest. Measurement variability increased with reduced angiographic quality, poor in-procedure QFR analysis quality, and more advanced coronary artery disease.
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