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

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

Klara Klarić orcid.org/0000-0002-4180-692X ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Zvonimir Ostojić ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Kristina Marić Bešić ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Boško Skorić ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Ivan Škorak ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Hrvoje Jurin ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Maja Strozzi ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Eduard Margetić ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Joško Bulum ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

Sažetak

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.

Ključne riječi

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

Hrčak ID:

236206

URI

https://hrcak.srce.hr/236206

Datum izdavanja:

26.3.2020.

Posjeta: 777 *