■在复杂的冠状动脉病变患者中,与药物洗脱支架(DES)-仅PCI相比,基于药物涂层球囊(DCB)的经皮冠状动脉介入治疗(PCI)的临床数据有限。
■本研究的目的是探讨DCB在复杂冠状动脉病变PCI患者中的疗效。
■来自新生复杂冠状动脉病变患者的机构注册,将126例接受基于DCB的PCI治疗的患者与234例仅接受DESPCI治疗的倾向评分匹配的患者进行比较。复杂的冠状动脉病变定义为至少存在以下1种情况:分叉,慢性完全闭塞,无保护的左主疾病,长病变≥38mm,多支血管疾病,需要≥3个装置的病变,或严重钙化.主要终点是2年时的目标血管衰竭(TVF),心脏死亡的复合物,靶血管相关心肌梗死,和目标血管血运重建。
■两组之间的基线特征相当。基于DCB的PCI显示TVF与基于DES的PCI的风险相当(7.6%vs8.1%;HR:0.81;95%CI:0.33-1.99;P=0.638)。心源性死亡的风险(5.0%vs5.7%;HR:0.78;95%CI:0.24-2.49),靶血管相关心肌梗死(0.9%vs1.3%;HR:2.65;95%CI:0.26-27.06),和靶血管血运重建(3.5%vs2.0%;HR:1.30;95%CI:0.30-5.67)在两组之间也具有可比性。
■基于DCB的PCI显示,在复杂冠状动脉病变患者中,TVF的风险与仅DESPCI的风险相当。在接受复杂PCI的患者中,DCB可能被认为是DES的合适替代设备。(接受CABG或PCI的患者的长期结果和预后因素;NCT03870815)。
UNASSIGNED: There are limited clinical data on drug-coated balloon (DCB)-based percutaneous coronary intervention (PCI) compared with drug-eluting stent (DES)-only PCI in patients with complex coronary artery lesions.
UNASSIGNED: The goal of the current study was to investigate the efficacy of DCB in patients undergoing PCI for complex coronary artery lesions.
UNASSIGNED: From an institutional registry of patients with de novo complex coronary artery lesions, 126 patients treated with DCB-based PCI were compared with 234 propensity score-matched patients treated with DES-only PCI. Complex coronary artery lesions were defined as the presence of at least 1 of the following: bifurcation, chronic total occlusion, unprotected left main disease, long lesion ≥38 mm, multivessel disease, lesion requiring ≥3 devices, or severe calcification. The primary endpoint was target vessel failure (TVF) at 2 years, a composite of cardiac death, target vessel-related myocardial infarction, and target vessel revascularization.
UNASSIGNED: Baseline characteristics were comparable between the 2 groups. DCB-based PCI showed a comparable risk of TVF vs DES-based PCI (7.6% vs 8.1%; HR: 0.81; 95% CI: 0.33-1.99; P = 0.638). The risks of cardiac death (5.0% vs 5.7%; HR: 0.78; 95% CI: 0.24-2.49), target vessel-related myocardial infarction (0.9% vs 1.3%; HR: 2.65; 95% CI: 0.26-27.06), and target vessel revascularization (3.5% vs 2.0%; HR: 1.30; 95% CI: 0.30-5.67) were also comparable between the 2 groups.
UNASSIGNED: DCB-based PCI showed comparable risks of TVF vs those of DES-only PCI in patients with complex coronary artery lesions. DCB might be considered as a suitable alternative device to DES in patients undergoing complex PCI. (Long-term Outcomes and Prognostic Factors in Patient Undergoing CABG or PCI; NCT03870815).