Drug-coated balloon vs drug-eluting stent in de novo coronary lesions: a propensity score matched cohort study.

IF 3.8 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Ulrike Baumer, Eva Steinacher, Andreas Hammer, Niema Kazem, Felix Hofer, Bernhard Frey, Irene Lang, Christian Hengstenberg, Rayyan Hemetsberger, Patrick Sulzgruber, Alexander Niessner, Lorenz Koller
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引用次数: 0

Abstract

Background: The use of drug-coated balloons (DCB) in percutaneous coronary interventions (PCI) is increasing due to potential benefits mainly by avoiding foreign material although a widespread application area beyond in-stent restenosis lacks robust clinical data to date. As such, we aimed to assess the safety and efficacy of DCBs in treating de novo lesions.

Methods: For this analysis, we included all patients treated with DCB in a de novo lesions from 2010 to 2019 at our institution. We performed a 1:1 propensity score matching to pair each DCB intervention with a comparable DES intervention. Follow-up continued until 09/2022 to assess clinical outcomes.

Results: A total of 303 patients with de novo lesion were matched to 303 patients with comparable baseline characteristics. The median follow-up time was 5.7 years (IQR 2.7-9.3). There were no significant differences in cardiovascular (CV) mortality (HR 1.01 [95% CI 0.87-1.19], p value 0.874), all-cause mortality (HR 1.05 [95% CI 0.91-1.22], p value 0.491), MACE (HR 1.10 [95% CI 0.96-1.26], p value 0.170), acute myocardial infarction (HR 1.08 [95% CI 0.90-1.19], p value 0.308), or any revascularization (HR 1.03 [95% CI 0.90-1.19], p value 0.671) between both groups. However, we observed a trend toward lower rates of target lesion revascularization in patients with small vessel disease (HR 0.84 [95% CI 0.68-1.02], p value 0.072), and in side branch lesions (HR 0.79 [95% CI 0.58-1.04], p value 0.096).

Conclusion: DCBs demonstrated long-term safety and efficacy in de novo lesions, with promising trends in reducing target lesion revascularization in small vessel disease and side branches.

药物包被球囊vs药物洗脱支架治疗新发冠状动脉病变:倾向评分匹配队列研究。
背景:药物包被球囊(DCB)在经皮冠状动脉介入治疗(PCI)中的应用越来越多,主要是由于避免了异物的潜在益处,尽管在支架内再狭窄之外的广泛应用领域迄今缺乏可靠的临床数据。因此,我们的目的是评估dcb治疗新发病变的安全性和有效性。方法:在本分析中,我们纳入了2010年至2019年在我们机构接受DCB治疗的所有新发病变患者。我们进行了1:1的倾向评分匹配,将每个DCB干预与可比的DES干预配对。随访持续到2022年9月,以评估临床结果。结果:共有303例新发病变患者与303例基线特征相似的患者相匹配。中位随访时间为5.7年(IQR为2.7-9.3)。两组患者的心血管(CV)死亡率(HR 1.01 [95% CI 0.87-1.19], p值0.874)、全因死亡率(HR 1.05 [95% CI 0.91-1.22], p值0.491)、MACE (HR 1.10 [95% CI 0.96-1.26], p值0.170)、急性心肌梗死(HR 1.08 [95% CI 0.90-1.19], p值0.308)或任何血流量重建(HR 1.03 [95% CI 0.90-1.19], p值0.671)均无显著差异。然而,我们观察到小血管病变患者的目标病变血运重建率较低(HR 0.84 [95% CI 0.68-1.02], p值0.072),而侧支病变患者的HR 0.79 [95% CI 0.58-1.04], p值0.096)。结论:DCBs在新生病变中表现出长期的安全性和有效性,在减少小血管疾病和侧支靶病变血运重建方面具有良好的趋势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical Research in Cardiology
Clinical Research in Cardiology 医学-心血管系统
CiteScore
11.40
自引率
4.00%
发文量
140
审稿时长
4-8 weeks
期刊介绍: Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.
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