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经紫杉醇涂层球囊的经皮冠状动脉介入治疗:真实世界多中心经验。

Percutaneous Coronary Intervention With the Agent Paclitaxel-Coated Balloon: A Real-World Multicenter Experience.

机构信息

Cardiology Division, Valduce Hospital, Via Dante Alighieri, 11, 22100 Como CO, Italy.

出版信息

J Invasive Cardiol. 2020 Mar;32(3):117-122. doi: 10.25270/jic/20.00016. Epub 2020 Feb 11.

Abstract

BACKGROUND

The Agent paclitaxel-coated balloon is a new drug-coated balloon (DCB) with few available real-world data. Our study sought to assess the safety and efficacy of the Agent DCB during percutaneous coronary intervention (PCI) in different coronary lesion types in a prospective registry.

METHODS AND RESULTS

All patients undergoing PCI with the Agent DCB at three Italian centers between September 2014 and March 2018 were included in this registry. Major adverse cardiac event (MACE) rate was defined as the composite of cardiac death, recurrent non-fatal myocardial infarction (MI), and target-lesion revascularization (TLR). Procedural success was also evaluated. Among the 354 patients included in the registry (450 lesions treated with 508 DCBs), Agent DCBs were used for the treatment of in-stent restenosis (ISR) in 34%, small-vessel disease (SVD) in 29%, bifurcation lesions in 26%, and "stent-like result" (SLR) lesions obtained after balloon predilation in 11%. The implantation of Agent DCBs was safe and had a high DCB lesion success rate of 92%. One-year MACE rate was 5.7% in the overall population. A higher MACE rate was observed in the ISR group (8.3%) vs the SVD group (3.6%; P=.03), with a trend toward higher event rates vs both BL (3.7%; P=.09) and SLR patients (5.5%; P=.54).

CONCLUSIONS

The use of Agent DCBs during PCI appears safe and effective in a large real-world registry. These results were maintained in all subgroups, with a slightly higher trend of events rates in the ISR setting, consistent with the higher-risk nature of this patient subset.

摘要

背景

Agent 紫杉醇涂层球囊是一种新型药物涂层球囊(DCB),目前仅有少量真实世界数据可用。我们的研究旨在评估 Agent DCB 在经皮冠状动脉介入治疗(PCI)中不同冠状动脉病变类型中的安全性和疗效,这是一项前瞻性注册研究。

方法和结果

该注册研究纳入了 2014 年 9 月至 2018 年 3 月期间在意大利三个中心接受 Agent DCB 治疗的所有患者。主要不良心脏事件(MACE)定义为心脏死亡、复发性非致死性心肌梗死(MI)和靶病变血运重建(TLR)的复合终点。还评估了手术成功率。该注册研究共纳入 354 例患者(共 450 处病变,使用 508 个 DCB),其中 Agent DCB 用于支架内再狭窄(ISR)患者 34%、小血管病变(SVD)患者 29%、分叉病变患者 26%、球囊预扩张后获得“支架样结果”(SLR)病变患者 11%。Agent DCB 的植入是安全的,且 DCB 病变成功率高,达到 92%。总体人群的 1 年 MACE 发生率为 5.7%。ISR 组的 MACE 发生率较高(8.3%),SVD 组(3.6%)较低(P=.03),与 BL 组(3.7%)和 SLR 患者(5.5%)相比,事件发生率也呈上升趋势(P=.09 和 P=.54)。

结论

在大型真实世界注册研究中,Agent DCB 在 PCI 中的应用是安全且有效的。这些结果在所有亚组中均得到维持,ISR 情况下的事件发生率略有上升趋势,与该患者亚组的高风险特征一致。

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