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Cardiologia Croatica, Vol. 18 No. 3-4, 2023.

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https://doi.org/10.15836/ccar2023.70

Incidence of restenosis after drug-coated balloon percutaneous coronary intervention in patients with chronic kidney disease – a single-centre experience

Antonio Hanžek orcid id orcid.org/0000-0003-2308-3518 ; University Hospital Centre Zagreb, Zagreb, Croatia
Zvonimir Ostojić orcid id orcid.org/0000-0003-1762-9270 ; University Hospital Centre Zagreb, Zagreb, Croatia
Filip Lončarić orcid id orcid.org/0000-0002-7865-1108 ; University Hospital Centre Zagreb, Zagreb, Croatia
Luka Perčin orcid id orcid.org/0000-0003-0497-6871 ; University Hospital Centre Zagreb, Zagreb, Croatia
Tomislav Krčmar orcid id orcid.org/0000-0003-4689-1673 ; University Hospital Centre Zagreb, Zagreb, Croatia
Kristina Marić-Bešić orcid id orcid.org/0000-0002-4004-7271 ; University Hospital Centre Zagreb, Zagreb, Croatia
Davor Radić orcid id orcid.org/0000-0002-9132-1568 ; University Hospital Centre Zagreb, Zagreb, Croatia
Marijan Pašalić orcid id orcid.org/0000-0002-3197-2190 ; University Hospital Centre Zagreb, Zagreb, Croatia
Denis Došen orcid id orcid.org/0000-0003-3490-5505 ; University Hospital Centre Zagreb, Zagreb, Croatia
Hrvoje Jurin ; University Hospital Centre Zagreb, Zagreb, Croatia
Boško Skorić orcid id orcid.org/0000-0001-5979-2346 ; University Hospital Centre Zagreb, Zagreb, Croatia
Eduard Margetić ; University Hospital Centre Zagreb, Zagreb, Croatia
Davor Miličić orcid id orcid.org/0000-0001-9101-1570 ; University Hospital Centre Zagreb, Zagreb, Croatia
Joško Bulum orcid id orcid.org/0000-0002-1482-6503 ; University Hospital Centre Zagreb, Zagreb, Croatia

Puni tekst: engleski pdf 180 Kb

str. 70-71

preuzimanja: 89

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Sažetak

Ključne riječi

chronic coronary disease; drug-coated balloons; PCI; restenosis; chronic kidney disease

Hrčak ID:

295847

URI

https://hrcak.srce.hr/295847

Datum izdavanja:

16.3.2023.

Posjeta: 246 *

Copyright: 2023, Croatian Cardiac Society

Date received: 19 February 2023

Date accepted: 22 February 2023

Publication date (print and electronic): March 2023

Volume: 18

Issue: 3-4

Pages: 70-71

Publisher ID: CC 2022 18_3-4_70-1

DOI: 10.15836/ccar2023.70

Article Information (continued)

Categories:

Subject: Extended Abstract

KEYWORDS: :

KEYWORDS:

Keyword: chronic coronary disease

Keyword: drug-coated balloons

Keyword: PCI

Keyword: restenosis

Keyword: chronic kidney disease

Incidence of restenosis after drug-coated balloon percutaneous coronary intervention in patients with chronic kidney disease – a single-centre experience

[https://orcid.org/0000-0003-2308-3518] Antonio Hanžek[1][*]

[https://orcid.org/0000-0003-1762-9270] Zvonimir Ostojić[1][2]

[https://orcid.org/0000-0002-7865-1108] Filip Lončarić[1]

[https://orcid.org/0000-0003-0497-6871] Luka Perčin[1]

[https://orcid.org/0000-0003-4689-1673] Tomislav Krčmar[1][2]

[https://orcid.org/0000-0002-4004-7271] Kristina Marić-Bešić[1][2]

[https://orcid.org/0000-0002-9132-1568] Davor Radić[1]

[https://orcid.org/0000-0002-3197-2190] Marijan Pašalić[1]

[https://orcid.org/0000-0003-3490-5505] Denis Došen[1]

[https://orcid.org/0000-0002-2599-553X] Hrvoje Jurin[1]

[https://orcid.org/0000-0001-5979-2346] Boško Skorić[1][2]

[https://orcid.org/0000-0001-9224-363X] Eduard Margetić[1][2]

[https://orcid.org/0000-0001-9101-1570] Davor Miličić[1][2]

[https://orcid.org/0000-0002-1482-6503] Joško Bulum[1][2]

 

[1] University Hospital Centre Zagreb, Zagreb, Croatia

[2] University of Zagreb School of Medicine, Zagreb, Croatia

Author notes:

Correspondence to: [*] ADDRESS FOR CORRESPONDENCE: Antonio Hanžek, KBC Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia. / Phone: +385-98-9426-056 / E-mail: antoniohanzek0@gmail.com

Introduction: The efficiency of drug-coated balloon (DCB) percutaneous coronary intervention (PCI) has been shown for in-stent restenosis (ISR) and native small-vessel disease, with available data showing similar outcomes in both chronic kidney disease (CKD) and non-CKD patients (1). The aim is to compare the incidence of target lesion restenosis at follow-up (FUP) coronary angiography in patients with and without CKD receiving DCB PCI.

Patients and Methods: The registry included patients undergoing a DCB PCI at the University Hospital Centre Zagreb from February 2011 to January 2023 (n=652). Patient demographics, comorbidities, pharmacotherapy, as well as data on the initial and FUP coronary angiography/PCI was collected. Chronic kidney disease was defined as estimated glomerular filtration rate < 45 ml/min/1.73m2. A FUP angiography was performed in 49% of patients (n=317), with a median FUP of 6 (interquartile range 3 - 18) months, without difference between groups.

Results: Data is shown inTable 1. The cohort was 75% male, mean age 65 ± 10 years. CKD was present in 9% (n=57) of patients and was associated with a higher incidence of arterial hypertension, diabetes mellitus, atrial fibrillation, as well as peripheral artery disease. The age difference was noted between groups, with CKD patients being older on average. At initial PCI, more CKD patients had multivessel coronary disease, with a higher rate of ISR as the indication for DCB, that was not statistically significant (CKD vs non-CKD: 46% vs 34%, p=0.075). After DCB, no difference was noted between groups in regards to the need for a bail-out PCI (9% VS 6%, P=0.375). FUP was performed in an equal percentage of patients in both groups (48% vs 51%, p=0.769), with no differences seen in the incidence of restenosis (17% vs. 18%, p=0.998), the need for target lesion PCI (17% vs. 13%, p=0.533), or the use of anti-anginal drugs.

TABLE 1 Comparison between chronic kidney disease (CKD) and non-CKD patients.
Patients with chronic kidney disease
(n=57)		Patients without
chronic kidney disease
(n=585)		P -value
Initial PCI hospitalization
Age, years (mean ± SD)72 ± 964 ± 10<0.001*
Male sex, n (%)38 (67)445 (76)0.147
History of myocardial infarction, n (%)31 (54)246 (42)0.073
History of PCI, n (%)39 (68)347 (59)0.180
History of CABG, n (%)5 (9)21 (4)0.071
History of stroke or TIA, n (%)7 (12)34 (6)0.057
History of atrial fibrillation, n (%)19 (33)61 (10)<0.001*
History of peripheral artery disease, n (%)11 (19)44 (8)<0.002*
Arterial hypertension, n (%)55 (97)502 (86)0.022*
Diabetes mellitus, n (%)32 (56)190 (33)<0.001*
ACS as indication for DCB PCI, n (%)25 (44)275 (47)0.679
Multivessel coronary disease, n (%)39 (70)292 (50)0.013*
In-stent restenosis, n (%)25 (46)194 (34)0.075
Bail-out PCI, n (%)5 (9)35 (6)0.375
Follow-up hospitalization
Elective procedure, n (%)18 (75)244 (84)0.261
Restenosis of target DCB PCI lesion, n (%)FUP cohort (n= 317)4 (17)51 (18)0.998
Whole cohort (n=645)4 (7)51 (9)0.808
SD – standard deviation, PCI – percutaneous coronary intervention, CABG – coronary artery bypass graft, TIA – transient ischemic attack, ACS – acute coronary syndrome, DCB – drug-coated balloon
*p<0.05

Conclusion: The findings of our single-centre analysis show that patients with CKD do not have a higher risk of target lesion restenosis after DCB PCI, when compared to the non-CKD group, which is in accordance with currently available evidence (2).

LITERATURE

1 

Jeger RV, Eccleshall S, Wan Ahmad WA, Ge J, Poerner TC, Shin ES, et al. International DCB Consensus Group. Drug-Coated Balloons for Coronary Artery Disease: Third Report of the International DCB Consensus Group. JACC Cardiovasc Interv. 2020 June 22;13(12):1391–402. https://doi.org/10.1016/j.jcin.2020.02.043 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/32473887

2 

Mahfoud F, Farah A, Ohlow MA, Mangner N, Wöhrle J, Möbius-Winkler S, et al. Drug-coated balloons for small coronary artery disease in patients with chronic kidney disease: a pre-specified analysis of the BASKET-SMALL 2 trial. Clin Res Cardiol. 2022 July;111(7):806–15. https://doi.org/10.1007/s00392-022-01995-3 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/35220449

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