背景:随着慢性全冠状动脉闭塞(CTO)再通技术和概念的进步,再通成功率一直在稳步提高。然而,目前的数据太有限,无法得出关于CTO经皮冠状动脉介入治疗(PCI)中药物涂层球囊(DCBs)的疗效和安全性的可靠结论.在这里,我们进行了一项荟萃分析,以证实DCB在CTOPCI中的疗效.
方法:我们系统地搜索了PubMed,WebofScience和Embase从成立到2023年7月25日。主要结局是主要的心血管事件(MACE),包括心脏死亡,非致死性心肌梗死(MI),靶病变血运重建(TLR),和目标血管血运重建(TVR)。随访血管造影终点为晚期管腔增大(LLE),再闭塞和再狭窄。
结果:5项研究共511名患者纳入荟萃分析。在整个研究中,患者主要为男性(72.9-85.7%),年龄超过50岁.MACE的总估计率为13.0%(95%CI10.1%-15.9%,I2=0%,p=0.428)。心源性死亡和MI的总估计率为2.2%(95%CI0.7%-3.7%,I2=0%,p=0.873)和1.2%(95%CI-0.2-2.6%,I2=13.7%,p=0.314),分别。最后,TLR和TVR的合并发生率为10.1%(95%CI5.7%-14.5%,I2=51.7%,p=0.082)和7.1%(95%CI3.0%-11.2%,I2=57.6%,p=0.070),分别。最后,LLE的汇总估计率,再闭塞和再狭窄为59.4%(95%CI53.5-65.3%,I2=0%,p=0.742),3.3%(95%CI1.1-5.4%,I2=0%,p=0.865)和17.5%(95%CI12.9-22.0%,I2=0%,p=0.623),分别。
结论:因此,DCB有潜力在合适的患者中用作CTO的治疗。
BACKGROUND: With advancements in chronic total coronary occlusion (CTO) recanalization techniques and concepts, the success rate of recanalization has been steadily increasing. However, the current data are too limited to draw any reliable conclusions about the efficacy and safety of drug-coated balloons (DCBs) in CTO percutaneous coronary intervention (PCI). Herein, we conducted a meta-analysis to confirm the efficacy of DCB in CTO PCI.
METHODS: We systematically searched PubMed, Web of Science and Embase from inception to July 25, 2023. The primary outcome was major advent cardiovascular events (MACE), including cardiac death, nonfatal myocardial infarction (MI), target lesion revascularization (TLR), and target vessel revascularization (TVR). The follow-up angiographic endpoints were late lumen enlargement (LLE), reocclusion and restenosis.
RESULTS: Five studies with a total of 511 patients were included in the meta-analysis. Across studies, patients were predominantly male (72.9-85.7%) and over fifty years old. The summary estimate rate of MACE was 13.0% (95% CI 10.1%-15.9%, I2 = 0%, p = 0.428). The summary estimate rates of cardiac death and MI were 2.2% (95% CI 0.7%-3.7%, I2 = 0%, p = 0.873) and 1.2% (95% CI -0.2-2.6%, I2 = 13.7%, p = 0.314), respectively. Finally, the pooled incidences of TLR and TVR were 10.1% (95% CI 5.7%-14.5%, I2 = 51.7%, p = 0.082) and 7.1% (95% CI 3.0%-11.2%, I2 = 57.6%, p = 0.070), respectively. Finally, the summary estimate rates of LLE, reocclusion and restenosis were 59.4% (95% CI 53.5-65.3%, I2 = 0%, p = 0.742), 3.3% (95% CI 1.1-5.4%, I2 = 0%, p = 0.865) and 17.5% (95% CI 12.9-22.0%, I2 = 0%, p = 0.623), respectively.
CONCLUSIONS: Accordingly, DCB has the potential to be used as a treatment for CTO in suitable patients.