Department of Internal Medicine, Division of Cardiology, Kangwon National University School of Medicine, Chuncheon.
Department of Cardiology, Ulsan Medical Center, Ulsan.
Coron Artery Dis. 2021 Sep 1;32(6):534-540. doi: 10.1097/MCA.0000000000001006.
Although drug-coated balloons (DCBs) are established for de-novo lesions in small coronary arteries, the impact of DCB treatment according to the reference vessel diameter (RVD) remains poorly defined. This study aimed to evaluate the angiographic and long-term clinical outcomes of DCB treatment for de-novo coronary lesions according to RVD.
A total of 227 patients were retrospectively enrolled and stratified according to an RVD >2.5 mm [nonsmall vessel disease (NSVD) group, n = 100] and ≤2.5 mm [small vessel disease (SVD) group, n = 127]. The primary endpoint was late lumen loss (LLL) at a 6-month follow-up, and the secondary endpoint was target vessel failure (TVF, a composite of cardiac death, target vessel myocardial infarction, target vessel revascularization and target vessel thrombosis). The LLL among the 206 patients (90.8%) returning for scheduled angiography at 6 month was similar (NSVD, 0.03 ± 0.22 mm vs. SVD, 0.06 ± 0.25 mm; P = 0.384). TVF was also comparable in both groups at a median follow-up of 3.4 years (NSVD, 7.0 vs. SVD, 7.9 %; P = 0.596). At baseline, there were numerically more dissections in the SVD group compared to the NSVD group (47.2 vs. 35.0 %; P = 0.064); however, most of these had disappeared in both groups at a 6-month follow-up. In a multivariable analysis, the presence of dissection was not associated with LLL or TVF in either group.
The safety and efficacy of DCB treatment for de-novo coronary lesions, in terms of LLL and TVF, was unrelated to RVD.
虽然药物涂层球囊（DCB）已被确立用于治疗小冠状动脉内的新生病变，但根据参考血管直径（RVD）进行 DCB 治疗的影响仍未得到明确界定。本研究旨在评估根据 RVD 对新生冠状动脉病变进行 DCB 治疗的血管造影和长期临床结局。
共回顾性纳入 227 例患者，并根据 RVD＞2.5mm（非小血管疾病[NSVD]组，n=100）和≤2.5mm（小血管疾病[SVD]组，n=127）进行分层。主要终点是 6 个月随访时的晚期管腔丢失（LLL），次要终点是靶血管失败（TVF，包括心脏死亡、靶血管心肌梗死、靶血管血运重建和靶血管血栓形成的复合终点）。206 例（90.8%）返回计划行 6 个月血管造影的患者的 LLL 相似（NSVD，0.03±0.22mm vs. SVD，0.06±0.25mm；P=0.384）。两组在中位数为 3.4 年的随访中 TVF 也相似（NSVD，7.0% vs. SVD，7.9%；P=0.596）。在基线时，SVD 组的夹层数量略多于 NSVD 组（47.2% vs. 35.0%；P=0.064）；然而，在 6 个月随访时，两组中的大多数夹层均已消失。多变量分析显示，夹层的存在与两组的 LLL 或 TVF 均无关。
在 LLL 和 TVF 方面，DCB 治疗新生冠状动脉病变的安全性和疗效与 RVD 无关。
