摘要Background Quantitative flow ratio(QFR)holds significant value in guiding drug-coated balloon(DCB)treatment and enhan-cing outcomes.However,the predictive capability of post-angioplasty QFR for long-term clinical events in patients with de novo lesions who receive DCB treatment remains uncertain.The aim of this study was to explore the potential significance of post-an-gioplasty QFR measurements in predicting clinical outcomes in patients underwent DCB treatment for de novo lesions.Methods Patients who underwent DCB-only intervention for de novo lesions were enrolled.QFR was conducted after DCB treatment.The patients were then categorized based on post-angioplasty QFR.The primary endpoint was major adverse cardiac events(MACE),encompassing all-cause death,cardiovascular death,nonfatal myocardial infarction,stroke,and target vessel re-vascularization.Results A total of 553 patients with 561 lesions were included.The median follow-up period was 505 days,during which 66(11.8%)MACEs occurred.Based on post-procedural QFR grouping,there were 259 cases in the high QFR group(QFR>0.93)and 302 cases in the low QFR group(QFR≤0.93).Kaplan-Meier analysis revealed a significantly higher cumulative incidence of MACE in the low QFR group(log-rank P=0.004).The multivariate Cox proportional hazards model demonstrated a significant inverse correlation between QFR and the occurrence of MACEs(HR=0.522,95%CI:0.289-0.942,P=0.031).Landmark analysis in-dicated that high QFR had a significant reducing effect on the cumulative incidence of MACEs within 1 year(log-rank P=0.016)and 1-5 years(log-rank P=0.026).Conclusions In patients who underwent DCB-only treatment for de novo lesions,higher post-procedural QFR values(>0.93)were identified as an independent protective factor against adverse prognosis.