QFR-Based Functional SYNTAX Score System in Optimizing Revascularization Strategy for Multivessel Disease

Inclusion criteria

• Age ≥ 18 years old;
• Diagnosed as MVD patient by coronary angiography (≥ 50% stenosis in ≥ 2 major vessels);
• Plan to undergo PCI or CABG treatment, and ensure that the contrast images meet the imaging quality requirements for QFR analysis;
• Voluntarily sign the informed consent form, be able to participate in randomization and cooperate in completing all follow-up visits.

Exclusion criteria

• Acute myocardial infarction requires emergency PCI;
• Severe left ventricular dysfunction (LVEF<30%) or cardiogenic shock;
• The quality of coronary angiography images is poor, such as vascular overlap, respiratory artifacts, projection angles less than 25 °, or frame rates less than 15 frames per second;
• Failure of QFR analysis due to severe calcified lesions (determined by the central laboratory);
• eGFR<30 mL/min/1.73m ² or contrast agent allergy;
• Patients using intravenous pressors, intra aortic balloon counterpulsation, or other mechanical circulatory support devices;
• Patients undergoing tracheal intubation treatment;
• Patients who have received thrombolytic therapy before admission;
• Pregnant women;
• Expected survival time<1 year due to non cardiac reasons;
• Patients who are not expected to receive antiplatelet therapy for at least 6 months;
• Patients who have received CABG treatment in the past or plan to receive CABG treatment;
• Patients who plan to undergo any surgical procedure within 6 months;
• There are other conditions that may interfere with follow-up, such as dementia, drug abuse including drug use and drug dependence for other reasons.