Quantitative flow ratio for the prediction of coronary events after percutaneous coronary intervention

The Multivessel TALENT trial is an ongoing randomised controlled trial comparing 2 drug-eluting stents in patients with de novo three-vessel disease without left main disease1. The study design mandates an offline assessment of quantitative flow ratio (QFR) pre-percutaneous coronary intervention (PCI) to prospectively identify which lesions should be treated. The rationale of this study lies in the post hoc analysis of the SYNTAX II trial, which established that a post-PCI QFR ≥0.91 was the optimal cut-off for a lower risk of 2-year vessel-oriented composite endpoints (VOCE). ClinicalTrials.gov: NCT04390672.

The current study was a vessel-based analysis using the post-PCI QFR from the first 775 patients randomised in the Multivessel TALENT study and was conducted before event adjudication commenced to forecast the rate of VOCE at 2 years for the entire population.

The details of the Multivessel TALENT trial design have been previously published1. The powered secondary endpoint is a superiority comparison in the per-protocol analysis of VOCE, a composite of vessel-related cardiovascular death, vessel-related myocardial infarction, and clinically and physiologically indicated target vessel revascularisation at 24 months post-procedure1.