ArticleJACC. Asia2026
Prognostic Value of Murray's Law-Based Quantitative Flow Ratio in Multi-Arterial Coronary Artery Bypass Grafting.
Article in JACC. Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05556590 (Impact of Preoperative Quantitative Flow Ratio on Radial Artery Graft Outcome After Coronary Artery Bypass Grafting in the ASRAB-Pilot Trial), which is not on this map. Cited by 1 paper.
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Impact of Preoperative Quantitative Flow Ratio on Radial Artery Graft Outcome After Coronary Artery Bypass Grafting in the ASRAB-Pilot Trial
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1 citing paper in PubMed.
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13 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe prognostic value of Murray's law-based quantitative flow ratio (μFR) in multi-arterial coronary artery bypass grafting (CABG) remains unclear.
objectivesThis study aims to investigate whether grafting strategies meeting μFR guidance improve mid-term outcomes following multi-arterial CABG.
methodsThis prospective secondary analysis included patients with available μFR analysis, clinical follow-up, and protocol-driven imaging from the ASRAB-Pilot (Different Anti-Spastic Strategy After CABG Using Radial Artery Grafts) trial. Patients were classified into μFR-guidance-met (all coronary lesions with μFR ≤0.80 were revascularized and all lesions with μFR >0.80 were not revascularized) or μFR-guidance-not-met groups. Outcomes included major adverse cardiac events (composite of death, myocardial infarction, stroke, or revascularization) and graft failure (Fitzgibbon grade B/S/O). Stabilized inverse probability weighting was applied to control confounding.
resultsAmong 141 patients analyzed, 77 (54.6%) met μFR guidance. At a median follow-up of 29.9 (Q1-Q3: 23.4-36.6) months, no significant difference in major adverse cardiac events was observed (μFR-guidance-met group: 16.0% [9.4%-26.5%] vs μFR-guidance-not-met group: 14.5% [7.8%-26.1%]; adjusted HR: 1.12, 95% CI: 0.47-2.66; P = 0.793). Graft-level analysis showed a significantly lower failure rate of arterial grafts with the μFR-guidance-met group (9.4% [n = 25 of 265] vs 34.9% [n = 15 of 43]; adjusted RR: 0.28; 95% CI: 0.16-0.50; P < 0.001) but not venous grafts (18.8% [n = 32 of 170] vs 22.2% [n = 6 of 27]; adjusted RR: 1.50; 95% CI: 0.61-3.68; P = 0.378).
conclusionsIn patients undergoing multi-arterial CABG, grafting strategies meeting μFR guidance were associated with a significantly lower failure rate of arterial grafts but not venous grafts. However, no improvement in mid-term clinical outcomes was observed, and larger trials are warranted in the future (Quantitative Flow Ratio on Radial Artery Graft Outcome After Coronary Artery Bypass Grafting [ASRAB-QUARGO]; NCT05556590).
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