Sharif Khan Hamid, Malik Jahanzeb, Mohsin Muhammad, Javed Asim, Farooq Muhammad Umar
Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK.
Cureus. 2020 Jun 8;12(6):e8500. doi: 10.7759/cureus.8500.
Objective To compare drug-eluting stents (DES) with drug-coated balloons (DCBs) in terms of major adverse cardiovascular and cerebrovascular events (MACCE) in patients who have undergone primary percutaneous coronary intervention (PPCI). Methodology Out of 210 angioplasties in six months, 80 patients were included; 40 in DES and 40 in DCB, respectively. All had a successful PPCI. It was defined as the achievement of thrombolysis in myocardial infarction (TIMI) grade II/III with <20% residual stenosis for the DES and TIMI grade II/III with <30% residual stenosis for the DCB. Any subsequent MACCE during the ensuing six months were assessed from emergency/outpatient records during their subsequent hospital visits, hospital registry, and telephonic interviews. Results The mean age in the DES group was 54.83 + 8.72 years while it was 56.8 + 8.9 years in the DCB group. The left anterior descending artery (LAD) was the culprit artery in the majority of the cases in both groups. The mean diameter of DES and DCB was 3.17 + 0.38 mm and 2.75 + 0.53 mm, respectively. Overall, 15 adverse events were seen in the DES group and 16 in the DCB group. The difference was insignificant (P-value = ≥ 0.999). There were nine hospitalizations due to chest pain in the DES group and eight in the DCB group. Total vessel revascularization (TVR) was seen in two patients in the DES group and three patients in the DCB group. None of the patients suffered a stroke. All variables of MACCE were non-significant (P-value = ≥ 0.999). Conclusion DCB appears to be non-inferior to DES in PPCI at a median follow-up of six months.
目的 比较药物洗脱支架(DES)与药物涂层球囊(DCB)在接受直接经皮冠状动脉介入治疗(PPCI)患者的主要不良心血管和脑血管事件(MACCE)方面的差异。方法 在六个月内进行的210例血管成形术中,纳入了80例患者;分别为40例使用DES和40例使用DCB。所有患者PPCI均成功。DES组定义为心肌梗死溶栓(TIMI)血流分级达到II/III级且残余狭窄<20%,DCB组定义为TIMI血流分级达到II/III级且残余狭窄<30%。通过随后医院就诊时的急诊/门诊记录、医院登记和电话访谈,评估随后六个月内发生的任何MACCE。结果 DES组的平均年龄为54.83±8.72岁,而DCB组为56.8±8.9岁。两组大多数病例的罪犯血管均为左前降支(LAD)。DES和DCB的平均直径分别为3.17±0.38mm和2.75±0.53mm。总体而言,DES组出现15例不良事件,DCB组出现16例。差异无统计学意义(P值≥0.999)。DES组有9例因胸痛住院,DCB组有8例。DES组有2例患者进行了完全血管重建(TVR),DCB组有3例。所有患者均未发生卒中。MACCE的所有变量均无统计学意义(P值≥0.999)。结论 在六个月的中位随访期内,DCB在PPCI中似乎不劣于DES。