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药物涂层球囊在老年人群冠状动脉病变治疗中的应用

Utilization of Drug-Coated Balloons for the Treatment of Coronary Lesions in the Elderly Population.

作者信息

Sella Gal, Gandelman Gera, Tuvali Ortal, Volodarsky Igor, Cuciuc Valeri, Haberman Dan, Ayyad Omar, Poles Lion, Welt Michael, Kracoff Oscar Horacio, George Jacob

机构信息

The Heart Center, Kaplan Medical Center, The Hebrew University of Jerusalem, 1 Pasternak St., Rehovot 7661041, Israel.

出版信息

J Clin Med. 2022 May 6;11(9):2616. doi: 10.3390/jcm11092616.

Abstract

Introduction: The use of drug-coated balloons (DCBs) has become more prevalent in the past few years for the treatment of in-stent restenosis (ISR) and de novo lesions. The absence of foreign polymer implantations potentially shortens the duration of dual anti-platelet therapy (DAPT), which can be beneficial for the elderly population. We aimed to investigate the safety and efficacy of the use of DCBs for the treatment of coronary lesions in elderly patients as compared to the younger population. Materials and methods: A database of 446 consecutive patients who underwent a procedure of DCB inflation in our institution was divided into two groups, below 70 years old and above 80 years old. We compared and analyzed the endpoints of total major adverse cardiovascular events (MACE), cardiovascular (CV) death, and all-cause mortality in both groups. Results: The difference in MACE between the two age groups was non-significant (p = 0.225); the difference in cardiovascular death was also non-significant (p = 0.086). All-cause mortality was significantly different (p < 0.0001) and can be attributed to the age of the patients. Conclusion: The utilization of DCBs for the treatment of coronary lesions may be as safe and effective for the elderly population as for the younger population and may allow a shorter period of DAPT therapy, which can lower the risk of bleeding.

摘要

引言

在过去几年中,药物涂层球囊(DCB)在治疗支架内再狭窄(ISR)和初发病变方面的应用越来越普遍。由于不存在外来聚合物植入,可能会缩短双联抗血小板治疗(DAPT)的持续时间,这对老年人群可能有益。我们旨在研究与年轻人群相比,使用DCB治疗老年患者冠状动脉病变的安全性和有效性。材料和方法:将我院446例连续接受DCB扩张术的患者数据库分为两组,年龄在70岁以下和80岁以上。我们比较并分析了两组的主要不良心血管事件(MACE)、心血管(CV)死亡和全因死亡率等终点指标。结果:两个年龄组之间的MACE差异无统计学意义(p = 0.225);心血管死亡差异也无统计学意义(p = 0.086)。全因死亡率有显著差异(p < 0.0001),这可能归因于患者的年龄。结论:使用DCB治疗冠状动脉病变对老年人群可能与年轻人群一样安全有效,并且可能允许较短疗程的DAPT治疗,从而降低出血风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a82/9099474/11d3f01be6c7/jcm-11-02616-g001.jpg

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