Long-term angiographic and clinical outcomes after coronary intervention using drug-coated balloons in acute coronary syndrome

    Authors

    Keywords

    acute coronary syndrome, percutaneous coronary intervention, in-stent restenosis, drug coated balloon

    DOI

    https://doi.org/10.15836/ccar2020.52

    Full Text

    Aim : Aim of the study was to compare angiographic and clinical outcomes after percutaneous coronary interventions (PCI) using drug coated balloons (DCB) between patients treated for “de novo” lesions and in-stent restenosis (ISR) in acute coronary syndrome (ACS). Patients and Methods : Study included 128 ASC patients treated with DCB between 2012 and 2019. All coronary angiographies were reviewed to determine indication, lesion complexity, vessel size and procedural success. Baseline and follow up clinical data were extracted from hospital digital database. Results : Mean patient age was 63.8 years, with the majority being men (75.8%, N=97). In total, 24 (18.8%) patients were treated for ISR. Comparison of clinical, angiographic and procedural characteristics between groups is presented in Table 1 . Patients in the non-ISR group had more often multivessel disease (56.7 vs 25.0%, p=0.005), bifurcation PCI (45.0 vs 20.8%, p=0.042) and more DCB used in the index event (1.1±0.3 vs 1.0±0, p=0.004). Furthermore, they had more concomitant PCI with stent implantation in other lesions (75.9 vs 33.3%, p<0.001) with consequent higher number of stents implanted per person (1.2 vs 0.5, p=0.002). Both mean DCB diameter and length were larger in the ISR group (2.85±0.59 mm vs 2.48±0.49 mm, p=0.007 and 23.38±3.23 vs 21.24±5.24 mm, p=0.012, respectively). In the non-ISR group 8 (7.7%) patients had “bail out” stent implantation, while none was done in ISR group. Mean angiographic and clinical follow up was not significantly different between groups ( Table 2 ). Altogether 75 (58.6%) patients underwent repeated coronary angiography, more often in the non-ISR group (64.4% vs 33.3%, p=0.005) but most of those were elective (73.1%). There was no significant difference in the composite endpoint consisted of death, unplanned rehospitalisation, target vessel revascularization and target lesion failure (ISR vs non-ISR; 29.2% vs 26.9%, p=0.82), nor in any of its components ( Table 2 ). Conclusions : DCB in treatment of native coronary arteries provides similar angiographic and clinical outcomes compared to DCB for ISR in patients presenting with ACS in real-world settings. ( 1 ) Furthermore, the prevalence of target lesion failure after DCB treatment was smaller in native coronary arteries compared to ISR.

    Cardiologia Croatica
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    Long-term angiographic and clinical outcomes after coronary intervention using drug-coated balloons in acute coronary syndrome

    Extended Abstract
    Issue3-4
    Published
    Pages52-53
    PDF via DOIhttps://doi.org/10.15836/ccar2020.52
    acute coronary syndrome
    percutaneous coronary intervention
    in-stent restenosis
    drug coated balloon

    Authors

    Klara Klarić*ORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Zvonimir OstojićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Kristina Marić BešićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Boško SkorićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Ivan ŠkorakORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Hrvoje JurinORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Maja StrozziORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Eduard MargetićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Joško BulumORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia

    Full Text

    Aim : Aim of the study was to compare angiographic and clinical outcomes after percutaneous coronary interventions (PCI) using drug coated balloons (DCB) between patients treated for “de novo” lesions and in-stent restenosis (ISR) in acute coronary syndrome (ACS). Patients and Methods : Study included 128 ASC patients treated with DCB between 2012 and 2019. All coronary angiographies were reviewed to determine indication, lesion complexity, vessel size and procedural success. Baseline and follow up clinical data were extracted from hospital digital database. Results : Mean patient age was 63.8 years, with the majority being men (75.8%, N=97). In total, 24 (18.8%) patients were treated for ISR. Comparison of clinical, angiographic and procedural characteristics between groups is presented in Table 1 . Patients in the non-ISR group had more often multivessel disease (56.7 vs 25.0%, p=0.005), bifurcation PCI (45.0 vs 20.8%, p=0.042) and more DCB used in the index event (1.1±0.3 vs 1.0±0, p=0.004). Furthermore, they had more concomitant PCI with stent implantation in other lesions (75.9 vs 33.3%, p<0.001) with consequent higher number of stents implanted per person (1.2 vs 0.5, p=0.002). Both mean DCB diameter and length were larger in the ISR group (2.85±0.59 mm vs 2.48±0.49 mm, p=0.007 and 23.38±3.23 vs 21.24±5.24 mm, p=0.012, respectively). In the non-ISR group 8 (7.7%) patients had “bail out” stent implantation, while none was done in ISR group. Mean angiographic and clinical follow up was not significantly different between groups ( Table 2 ). Altogether 75 (58.6%) patients underwent repeated coronary angiography, more often in the non-ISR group (64.4% vs 33.3%, p=0.005) but most of those were elective (73.1%). There was no significant difference in the composite endpoint consisted of death, unplanned rehospitalisation, target vessel revascularization and target lesion failure (ISR vs non-ISR; 29.2% vs 26.9%, p=0.82), nor in any of its components ( Table 2 ). Conclusions : DCB in treatment of native coronary arteries provides similar angiographic and clinical outcomes compared to DCB for ISR in patients presenting with ACS in real-world settings. ( 1 ) Furthermore, the prevalence of target lesion failure after DCB treatment was smaller in native coronary arteries compared to ISR.