Performance of angiographic quantitative flow ratio in guid-ing coronary interventions across different age groups:pres-pecified subgroup analysis of the FAVOR Ⅲ China trial
Xin-Ye XU
Li-Yun HE
Chang-Dong GUAN
Ming CUI
Yu-Peng WANG
Yu-Jie ZHOU
Jian-An WANG
Jun BU
Liang-Long CHEN
Xin-Kai QU
Jun-Qing YANG
Yan-Yan ZHAO
Xue-Bo LIU
Cheng-Xing SHEN
Sheng-Xian TU
Gregg STONE
Li-Jun GUO
Lei SONG
Abstract：Background: Quantitative flow ratio (QFR) based lesion selection for percutaneous coronary intervention (PCI) treatment has shown clinical benefits in terms of reduced risk for myocardial infarction and repeat revascularization. Whether this benefit is consistent across different age groups still needs further investigation.
Methods: In this prespecified subgroup study of FAVOR III China trial, we compared long-term clinical outcomes between QFR-guided and angiography-guided PCI among different age groups among 3825 enrolled subjects. The primary endpoint was major adverse cardiac events (MACEs), a composite of all-cause death, myocardial infarction, and ischemia-driven revascularization.
Results: Of the 3825 patients, 1717 (44.9%) were aged ≥65 years. At baseline, patients ≥65 had higher rates of hypertension, hyperlipidaemia, stroke history (P<0.0001), and peripheral vascular disease (P=0.024) and had higher SYNTAX scores (P=0.0095). Compared with standard angiography guidance, the QFR-guided strategy consistently reduced the 1-year (≥65 years, 6.04% vs. 9.19%, HR=0.65, 95%CI: 0.46-0.92; <65 years, 5.53% vs. 8.43%, HR=0.65, 95%CI: 0.47-0.91) and 3-year MACE rates in both age groups (≥65 years, 11.8% vs. 15.2%, HR: 0.75, 95%CI: 0.58-0.98; <65 years, 9.5% vs. 14.6%, HR=0.63; 95%CI: 0.49-0.81), without a significant interaction (Pinteraction=0.99). Within the QFR-guided group, the 3-year MACE rate in patients with deferred vessels was numerically greater in patients aged ≥65 years than in those aged <65 years (8.3% vs. 3.0%, P=0.10).
Conclusions: Although with higher rate of comorbidities and more complex coronary anatomy, the long-term benefit of the QFR-guided PCI strategy remained consistent in patients ≥65 years, compared with those <65 years.
Machine-generated Keywords：
Publication Date：2025-11-30
Online Publishing Date：2026-01-09(First online date of this platform, not the publication date of the document)
Pages：13( 887-899 )