Drug-coated balloons for the treatment of ostial left anterior descending or ostial left circumflex artery lesions:a patientlevel propensity score-matched analysis  

作　　者：Liang PAN Wen-Jie LU Zhan-Ying HAN San-Cong PAN Xi WANG Ying-Guang SHAN Meng PENG Xiao-Fei QIN Guo-Ju SUN Pei-Sheng ZHANG Jian-Zeng DONG Chun-Guang QIU 

机构地区：[1]Department of Cardiovascular Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,China [2]Department of Cardiology,Jincheng People’s Hospital,Jincheng,China [3]Department of Cardiology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,China

出　　处：《Journal of Geriatric Cardiology》2023年第10期716-727,I0001-I0005,共17页老年心脏病学杂志（英文版）

基　　金：supported by the Medical Science and Technique Research Plan of He’nan Province(Provincial and Ministerial Co-construction Project)(SB201901027).

摘　　要：BACKGROUND Controversy exists as to the optimal treatment approach for ostial left anterior descending(LAD)or ostial left circumflex artery(LCx)lesions.Drug-coated balloons(DCB)may overcome some of the limitations of drug-eluting stents(DES).Therefore,we investigated the security and feasibility of the DCB policy in patients with ostial LAD or ostial LCx lesions,and compared it with the conventional DES-only strategy.METHODS We retrospectively enrolled patients with de novo ostial lesions in the LAD or LCx who underwent interventional treatment.They were categorized into two groups based on their treatment approach:the DCB group and the DES group.The treatment strategies in the DCB group involved the use of either DCB-only or hybrid strategies,whereas the DES group utilized crossover or precise stenting techniques.Two-year target lesion revascularization was the primary endpoint,while the rates of major adverse cardiovascular events,cardiac death,target vessel myocardial infarction,and vessel thrombosis were the secondary endpoints.Using propensity score matching,we assembled a cohort with comparable baseline characteristics.To ensure result analysis reliability,we conducted sensitivity analyses,including interaction,and stratified analyses.RESULTS Among the 397 eligible patients,6.25%of patients who were planned to undergo DCB underwent DES.A total of 108 patients in each group had comparable propensity scores and were included in the analysis.Two-year target lesion revascularization occurred in 5 patients(4.90%)and 16 patients(16.33%)in the DCB group and the DES group,respectively(odds ratio=0.264,95%CI:0.093–0.752,P=0.008).Compared with the DES group,the DCB group demonstrated a lower major adverse cardiovascular events rate(7.84%vs.19.39%,P=0.017).However,differences with regard to cardiac death,non-periprocedural target vessel myocardial infarction,and definite or probable vessel thrombosis between the groups were non-significant.CONCLUSIONS The utilization of the DCB approach signifies an innovative and d

关 键 词：LESIONS BALLOON TREATMENT 

分 类 号：R541.4[医药卫生—心血管疾病]