Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, No. 258 of Wenhua Road, Qinhuangdao, 066000, Hebei Province, China.
Intern Emerg Med. 2021 Jun;16(4):913-918. doi: 10.1007/s11739-020-02530-w. Epub 2021 Jan 1.
There were good clinical outcomes of drug-eluting balloon (DEB) use in de novo lesions and in-stent restenosis (ISR) lesions. However, few studies focused on DEB use in patients with acute myocardial infarction (AMI). The aim of this study was to retrospective evaluate the efficacy of DEB for patients of AMI with de novo small coronary artery disease. Between March 2016 and March 2018, patients of AMI with de novo small coronary artery (reference diameter 2.0-2.8 mm) and received percutaneous coronary intervention (PCI) were enrolled. 268 patients were divided into DEB group (PCI with further DEB, n = 56) and drug-eluting stent (DES) group (PCI with further DES, n = 212). The primary endpoint was major adverse cardiac events (MACE; all-cause death, non-fatal myocardial infarction, target lesion revascularization and target vessel revascularization) at 24 months. A subset of patients underwent angiographic follow-up. Clinical characteristics were balanced in the two groups. Mean reference vessel diameter was similar between the DEB and DES groups (2.64 ± 0.17 mm vs 2.65 ± 0.14 mm, P = 0.625). The 24-month MACE rates were 17.5% in DEB group and 16.4% in DES group (P = 0.853). Stent thrombosis was seen in three patients (1.46%) in DES group. There was no vessel thrombosis noted in the DEB group. Angiographic follow-up was performed in 35.71% of DEB group and 27.25% of DES group. Late lumen loss was similar between the two groups (DEB 0.14 ± 0.13 mm, DES 0.19 ± 0.12 mm, P = 0.442). DEB is a reasonable strategy for AMI with small coronary artery. Compared with DES, DEB is an alternative strategy which had similar 24-month clinical outcomes.
药物洗脱球囊（DEB）在新发病变和支架内再狭窄（ISR）病变中的应用具有良好的临床效果。然而，很少有研究关注 DEB 在急性心肌梗死（AMI）患者中的应用。本研究旨在回顾性评估 DEB 治疗新发小冠状动脉疾病的 AMI 患者的疗效。2016 年 3 月至 2018 年 3 月，纳入 AMI 合并新发小冠状动脉（参考直径 2.0-2.8mm）且接受经皮冠状动脉介入治疗（PCI）的患者。268 例患者分为 DEB 组（PCI 后进一步行 DEB，n=56）和药物洗脱支架（DES）组（PCI 后进一步行 DES，n=212）。主要终点是 24 个月时的主要不良心脏事件（MACE；全因死亡、非致死性心肌梗死、靶病变血运重建和靶血管血运重建）。部分患者进行了血管造影随访。两组患者的临床特征平衡。DEB 组和 DES 组的平均参考血管直径相似（2.64±0.17mm 比 2.65±0.14mm，P=0.625）。DEB 组 24 个月的 MACE 发生率为 17.5%，DES 组为 16.4%（P=0.853）。DES 组有 3 例（1.46%）发生支架血栓。DEB 组未见血管血栓形成。DEB 组中有 35.71%的患者进行了血管造影随访，DES 组中有 27.25%的患者进行了血管造影随访。两组的晚期管腔丢失相似（DEB 组 0.14±0.13mm，DES 组 0.19±0.12mm，P=0.442）。DEB 是治疗小冠状动脉 AMI 的合理策略。与 DES 相比，DEB 是一种替代策略，其 24 个月的临床结局相似。
