ABS20191105_0008
Drug-Eluting Balloons
Midterm Clinical Outcomes After Emergent Drug-Coated Balloon Dilation Versus Drug-Eluting Stents Placement for Acute Coronary Syndrome: A Single-Center Retrospective Study
Hideyuki Aoki1, Tetsuya Ishikawa2, Taro Takeyama3, Kota Yamada1, Yukiko Mizutani1, Hidehiko Nakamura1, Yoshihiko Sakai1, Isao Taguchi1
Dokkyo Medical University, Japan1, Dokkyo Medical University, Saitama Medical Center, Japan2, Dokkyo Medical University Saitama Medical Center, Japan3
Background:
Impact of drug-coated balloon (DCB) for patients with acute coronary syndrome (ACS) was not fully understood. Therefore, we conducted a single-center retrospective comparison of midterm clinical outcomes after emergent use of DCB for de novo coronary stenosis in patients with acute coronary syndrome (ACS) with those of drug-eluting stent (DES).
Methods:
For this purpose, 17 variables including patient, lesion, and procedure characteristics, and quantitative coronary angiogram (QCA) were investigated in DCB (n=54) and DES (n=88) groups after successfully treatment during from 2017 December to 2019 March. The primary endpoint was the incidence of target lesion failure (TLF) comprising of cardiac death without in-hospital death in patients with cardiogenic shock, non-fatal myocardial infarction, and any target lesion revascularization including acute occlusion after DCB use and definite stent thrombosis after DES placement. The impact of DCB on TLF was estimated by adjusting the different values of 17 baseline variables using a Cox hazard proportional analysis.
Results:
The mean balloon size (2.81¡¾0.59 mm) and total device length (19.7¡¾4.7 mm) of DCB were significantly different from those of DES (3.60¡¾0.52 mm, 30.5¡¾16.2 mm, p<0.001, respectively). The incidence of TLF in DCB group (7.4% during the mean observational interval of 370¡¾263 days) was not significantly different from that of DES group (9.2% during 288¡¾249 days). Cumulated TLF-free ratio in DCB group was not significantly different from that in DES group (p=0.290, log-rank test). There were none of significant predictor of TLF, including DCB (hazard ratio: <0.01, 95% CI: <0.01-4.65, p=0.102).
Conclusion:
The present study showed the statistically equivalent midterm clinical outcome of DCB for de novo coronary stenosis in patients with ACS as with DES in a daily practice.
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