IMR Press / RCM / Volume 23 / Issue 2 / DOI: 10.31083/j.rcm2302059
Open Access Original Research
Comparison of diagnostic accuracy of immediate angiography derived residual quantitative flow ratio after bioresorbable scaffold and drug eluting stent implantation
Zhengwei Li1,2Jiachen Zhan1,3Jia Han1Guosheng Fu1,2,*,†Chongying Jin1,2,*,†
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1 Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 310016 Hangzhou, Zhejiang, China
2 Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, 310016 Hangzhou, Zhejiang, China
3 Department of Cardiology, Zhuji People’s Hospital, 311800 Shaoxing, Zhejiang, China
*Correspondence: (Guosheng Fu); (Chongying Jin)
These authors contributed equally.
Academic Editors: Brian Tomlinson and Takatoshi Kasai
Rev. Cardiovasc. Med. 2022, 23(2), 59;
Submitted: 2 November 2021 | Revised: 9 December 2021 | Accepted: 13 December 2021 | Published: 12 February 2022
(This article belongs to the Special Issue State-of-the-Art Cardiovascular Medicine in Asia 2021)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Quantitative flow ratio (QFR) is a novel angiography derived fractional flow reserve (FFR) technique. However, its diagnostic accuracy has only be validated in native coronary lesions but not in vessels after bioresorbable scaffold (BRS) implantation. This study aims to evaluate the diagnostic accuracy of residual QFR in coronary vessels immediately post-BRS implantation. Methods: This is a retrospective, two center, validation cohort study. 73 stable angina patients who received at least one de novo lesion of an everolimus eluting stent (EES)/BRS implantation with subsequent residual FFR assessment were screened. Patients with aorta-ostial stenoses, bridge vessels at the distal segment of targeted vessels, acute coronary syndrome, previous coronary artery bypass grafting, age <18 years, lack of 2 final angiographic projections were excluded. Contrast QFR assessment was performed blinded to FFR assessment. Results: A good correlation (r = 0.680, p < 0.001) was found between residual QFR and FFR. In the EES implantation cohort, a good correlation (r = 0.769, p < 0.001) was found between residual QFR and FFR, and a moderate correlation (r = 0.446, p = 0.038) in the BRS cohort. The area under the Receiver operator characteristic (ROC) curve for detecting FFR 0.86 was 0.883 for all patients. Conclusion: Residual QFR assessment after BRS implantation is feasible, and has a moderate correlation and agreement with residual FFR. QFR may be a promising tool similar to FFR to evaluate post-BRS effect.

Quantitative flow ratio
Bioresorbable scaffold
Fractional flow reserve
Coronary de novo lesion
Everolimus eluting stent
Fig. 1.
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