{"title":"药物涂层球囊在冠状动脉小血管和大血管新发病变中的疗效和长期疗效。","authors":"Hesham Refaat, Mohamed Arab","doi":"10.1016/j.ihj.2025.03.015","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Drug eluting stent (DES) could result in both in-stent restenosis and high bleeding risk due to long-term anti-platelet therapy. Drug-coated balloon (DCB) delivers anti-proliferative drugs without implanting metal into vascular wall. Our aim was to investigate its feasibility in large vessel coronary artery disease (LvCAD), compared to small vessel coronary artery disease (SvCAD).</p><p><strong>Methods: </strong>This study enrolled 237 patients with de novo coronary lesions treated with DCB-only strategy and categorized according to the reference vessel diameter of 3 mm into SvCAD and LvCAD groups. The primary endpoint was in-lesion late lumen loss (LLL). The secondary endpoints included composite major adverse cardiac events (MACE), cardiac death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and vessel thrombosis.</p><p><strong>Results: </strong>The immediate (3.06 ± 0.25 vs. 2.33 ± 0.21 mm, p=0.001) and follow up minimal lumen diameter (3.13 ± 0.25 vs. 2.41 ± 0.21 mm, p=0.001) and acute gain (1.92 ± 0.29 vs. 1.5 ± 0.26 mm, p=0.04) were significantly higher in LvCAD group. In-lesion LLL was negative without significant difference (- 0.07 ± 0.02 vs. - 0.06 ± 0.04 mm, p=0.69). The incidence of adverse clinical events was not statistically significant accounting for 6.5% vs. 10.5% for composite MACE (p=0.27), 0.8% vs. 0.9% for cardiac death (p=0.96), 4.9% vs.7% for non-fatal MI (p=0.49), 4.1% vs. 6.1% for TLR (p=0.47), 2.4% vs. 3.5% for TVR (p=0.63) and 1.6% vs. 2.6% for vessel thrombosis (p=0.59).</p><p><strong>Conclusion: </strong>DCB-only strategy is effective in treating LvCAD with comparable outcomes to SvCAD.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy and Long-Term Outcomes of Drug Coated Balloon in De Novo Lesions of Small Versus Large Coronary Vessels.\",\"authors\":\"Hesham Refaat, Mohamed Arab\",\"doi\":\"10.1016/j.ihj.2025.03.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Drug eluting stent (DES) could result in both in-stent restenosis and high bleeding risk due to long-term anti-platelet therapy. Drug-coated balloon (DCB) delivers anti-proliferative drugs without implanting metal into vascular wall. Our aim was to investigate its feasibility in large vessel coronary artery disease (LvCAD), compared to small vessel coronary artery disease (SvCAD).</p><p><strong>Methods: </strong>This study enrolled 237 patients with de novo coronary lesions treated with DCB-only strategy and categorized according to the reference vessel diameter of 3 mm into SvCAD and LvCAD groups. The primary endpoint was in-lesion late lumen loss (LLL). The secondary endpoints included composite major adverse cardiac events (MACE), cardiac death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and vessel thrombosis.</p><p><strong>Results: </strong>The immediate (3.06 ± 0.25 vs. 2.33 ± 0.21 mm, p=0.001) and follow up minimal lumen diameter (3.13 ± 0.25 vs. 2.41 ± 0.21 mm, p=0.001) and acute gain (1.92 ± 0.29 vs. 1.5 ± 0.26 mm, p=0.04) were significantly higher in LvCAD group. In-lesion LLL was negative without significant difference (- 0.07 ± 0.02 vs. - 0.06 ± 0.04 mm, p=0.69). The incidence of adverse clinical events was not statistically significant accounting for 6.5% vs. 10.5% for composite MACE (p=0.27), 0.8% vs. 0.9% for cardiac death (p=0.96), 4.9% vs.7% for non-fatal MI (p=0.49), 4.1% vs. 6.1% for TLR (p=0.47), 2.4% vs. 3.5% for TVR (p=0.63) and 1.6% vs. 2.6% for vessel thrombosis (p=0.59).</p><p><strong>Conclusion: </strong>DCB-only strategy is effective in treating LvCAD with comparable outcomes to SvCAD.</p>\",\"PeriodicalId\":13384,\"journal\":{\"name\":\"Indian heart journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-03-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian heart journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ihj.2025.03.015\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian heart journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.ihj.2025.03.015","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Efficacy and Long-Term Outcomes of Drug Coated Balloon in De Novo Lesions of Small Versus Large Coronary Vessels.
Objective: Drug eluting stent (DES) could result in both in-stent restenosis and high bleeding risk due to long-term anti-platelet therapy. Drug-coated balloon (DCB) delivers anti-proliferative drugs without implanting metal into vascular wall. Our aim was to investigate its feasibility in large vessel coronary artery disease (LvCAD), compared to small vessel coronary artery disease (SvCAD).
Methods: This study enrolled 237 patients with de novo coronary lesions treated with DCB-only strategy and categorized according to the reference vessel diameter of 3 mm into SvCAD and LvCAD groups. The primary endpoint was in-lesion late lumen loss (LLL). The secondary endpoints included composite major adverse cardiac events (MACE), cardiac death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and vessel thrombosis.
Results: The immediate (3.06 ± 0.25 vs. 2.33 ± 0.21 mm, p=0.001) and follow up minimal lumen diameter (3.13 ± 0.25 vs. 2.41 ± 0.21 mm, p=0.001) and acute gain (1.92 ± 0.29 vs. 1.5 ± 0.26 mm, p=0.04) were significantly higher in LvCAD group. In-lesion LLL was negative without significant difference (- 0.07 ± 0.02 vs. - 0.06 ± 0.04 mm, p=0.69). The incidence of adverse clinical events was not statistically significant accounting for 6.5% vs. 10.5% for composite MACE (p=0.27), 0.8% vs. 0.9% for cardiac death (p=0.96), 4.9% vs.7% for non-fatal MI (p=0.49), 4.1% vs. 6.1% for TLR (p=0.47), 2.4% vs. 3.5% for TVR (p=0.63) and 1.6% vs. 2.6% for vessel thrombosis (p=0.59).
Conclusion: DCB-only strategy is effective in treating LvCAD with comparable outcomes to SvCAD.
期刊介绍:
Indian Heart Journal (IHJ) is the official peer-reviewed open access journal of Cardiological Society of India and accepts articles for publication from across the globe. The journal aims to promote high quality research and serve as a platform for dissemination of scientific information in cardiology with particular focus on South Asia. The journal aims to publish cutting edge research in the field of clinical as well as non-clinical cardiology - including cardiovascular medicine and surgery. Some of the topics covered are Heart Failure, Coronary Artery Disease, Hypertension, Interventional Cardiology, Cardiac Surgery, Valvular Heart Disease, Pulmonary Hypertension and Infective Endocarditis. IHJ open access invites original research articles, research briefs, perspective, case reports, case vignette, cardiovascular images, cardiovascular graphics, research letters, correspondence, reader forum, and interesting photographs, for publication. IHJ open access also publishes theme-based special issues and abstracts of papers presented at the annual conference of the Cardiological Society of India.