Predictive Value Of Post-percutaneous Coronary Intervention Quantitative Flow Ratio For Vessel-oriented Composite Endpoint:A Meta-Analysis

Objective:Coronary atherosclerotic heart disease(CHD)is one of the most common cardiovascular diseases in clinical practice.many patients continue to experience adverse events after successful percutaneous coronary intervention(PCI).long-term prognosis of CHD patients can be predicted by GRACE,PURSUIT,and TIMI risk scores,intravascular ultrasound(IVUS),optical coherence tomography(OCT),and fractional flow reserve(FFR),these methods have some limitations.Recent studies showed that post-PCI quantitative flow ratio(QFR)has a good predictive value for the vessel-oriented composite endpoint(VOCE).In this paper,we intend to search the related literature of post-PCI QFR predicting post-PCI VOCE in CHD patients and makea meta-analysis.Methods:Pub Med,Embase,and Cochrane were searched from inception to March 27,2022,and the cohort studies of post-PCI QFR predicting VOCE were screened.A meta-analysis was performedusing the Stata software.Results:6/203 cohort studies were included.The patients were divided into two cohorts------the lower and higher QFR groups(cutoff value:0.89–0.94).The effect quantity and confidence interval were assessed according to the hazard ratio(HR)after adjusting for other factors.The risk of the VOCE was significantly higher in the lower QFR group than in the higher QFR group(HR:4.14,95%CI:3.18-5.41,P<0.001,I~2=27.9%).The funnel plots are symmetric,indicating that there is no publication bias.Egger’s test and Begg’s test also showed no publication bias(P=0.804 and P=1.000,respectively).All results of the subgroup analysis were conducted according to the country;the PCI type and follow-up time were similar.Next,the meta-analysis was performed according to the occurrence of endpoint events of the two cohorts.The primary endpoint was VOCE,and the secondary endpoint was vessel-related cardiovascular death(CV deaths),vessel-related myocardial infarction(TVMI),and ischemia-driven target vessel revascularization(TVR).The results also showed that the risk of the VOCE was significantly higher in the lower QFR group than in the higher QFR group.Conclusion:Post-PCIQFR is expected to be a simple and reliable approach to predicting CHD patients’long-term prognosis.Nonetheless,additional prospective studies with larger sample sizes are needed toclarify the predictivevalue of this approach.