Eun-Seok Shin, Sunwon Kim, Dong Oh Kang, Bitna Kim, Ae-Young Her
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引用次数: 0
Abstract
Introduction and objectives: There are limited data on drug-coated balloon (DCB) treatment for de novo diffuse coronary artery disease (CAD). This study aimed to evaluate the clinical impact of DCB-based percutaneous coronary intervention (PCI) in patients with de novo diffuse long CAD.
Methods: We retrospectively included 623 patients with single de novo diffuse CAD (≥ 30 mm). These patients underwent PCI exclusively for the target lesion and were successfully treated with DCB-based PCI. They were compared with 623 propensity-matched patients who underwent conventional PCI with second-generation drug-eluting stents (DES) for diffuse CAD (DES-only group). The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of cardiac death, myocardial infarction, stent or target lesion thrombosis, target vessel revascularization, and major bleeding at 2 years.
Results: In the DCB-based group, 73.7% of patients were treated with DCB alone. The MACE rate was significantly lower in the DCB-based group than in the DES-only group (4.6% vs 14.6%; hazard ratio: 0.29; 95% confidence interval: 0.18-0.47; P < .001). Rates of target vessel revascularization (3.1% vs 9.7%; P < .001) and major bleeding events (0.8% vs 2.7%; P = .008) were also lower with DCB-based PCI than with DES-only PCI. In a multivariable model, DCB-based PCI was independently associated with a lower risk of 2-year MACE, target vessel revascularization, and major bleeding.
Conclusions: In patients with de novo diffuse CAD, DCB-based PCI was associated with a significant reduction in MACE compared with DES-only PCI.
前言和目的:药物包被球囊(DCB)治疗新发弥漫性冠状动脉疾病(CAD)的数据有限。本研究旨在评估基于dbc的经皮冠状动脉介入治疗(PCI)对新发弥漫性长时间冠心病患者的临床影响。方法:我们回顾性纳入623例新发弥漫性CAD(≥30 mm)患者。这些患者接受了专门针对目标病变的PCI,并成功地接受了基于dbc的PCI治疗。他们与623名倾向匹配的接受常规PCI +第二代药物洗脱支架(DES)治疗弥漫性CAD的患者(DES组)进行比较。主要终点是主要心血管不良事件(MACE),定义为心脏性死亡、心肌梗死、支架或靶病变血栓形成、靶血管重建术和2年大出血的复合。结果:在以DCB为基础的组中,73.7%的患者单用DCB治疗。dcb组的MACE率明显低于des组(4.6% vs 14.6%;风险比:0.29;95%置信区间:0.18-0.47;P < 0.001)。靶血管重建率(3.1% vs 9.7%;P < 0.001)和大出血事件(0.8% vs 2.7%;P = 0.008)基于dbc的PCI也低于仅des的PCI。在多变量模型中,基于dbc的PCI与2年MACE、靶血管重建术和大出血的风险较低独立相关。结论:在新发弥漫性CAD患者中,与仅des的PCI相比,基于dbc的PCI与MACE的显著降低相关。