Fong Alan Yean Yip, Said Asri, Oon Yen Yee, Koh Keng Tat, Ho Kian Hui, Shu Francis Eng Pbeng, Tan Chen Ting, Bhavnani Chandan Deepak, Lee Shaun Wen Huey, Liu Kien Ting, Cham Yee Ling, Ong Tiong Kiam
Department of Cardiology, Sarawak Heart Centre, Ministry of Health Malaysia, Kota Samarahan, Malaysia.
Clinical Research Centre, Institute for Clinical Research, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia.
J Soc Cardiovasc Angiogr Interv. 2024 Feb 15;3(5):101295. doi: 10.1016/j.jscai.2024.101295. eCollection 2024 May.
In percutaneous coronary intervention (PCI) of de novo lesions, drug-coated balloons (DCB) have been shown to be a promising strategy to improve clinical outcomes of patients with small vessel disease. Evidence of this strategy in PCI of de novo coronary lesions in a real-world setting is limited. The objective of this study was to compare the 12-month outcomes of 2 paclitaxel-coated balloon systems for the treatment of all de novo coronary artery lesions.
All patients who were treated for de novo coronary artery stenosis with either SeQuent Please or In.Pact Falcon DCB at a single center from January 2014 to December 2018 were included. The primary end point was the composite of cardiac death, nonfatal myocardial infarction, and target vessel revascularization (3-point major adverse cardiovascular events) at 12 months.
A total of 496 patients with 623 lesions, of which 144 were treated with SeQuent Please and 352 were treated with In.Pact Falcon were included in the study. Baseline patient, lesion and procedural characteristics at baseline were similar between groups. At 12-month follow-up, 3-point major adverse cardiovascular event outcomes were similar (4.2% vs 2.3% respectively; = .272). Deaths due to cardiovascular events were few and similar between groups (2.7% vs 1.1% respectively; = .20).
Both paclitaxel DCB systems have similar efficacy and safety outcomes, suggesting that both may be an appropriate treatment choice for patients with de novo lesions. However, a larger randomized controlled study is needed to confirm these findings.
在初发病变的经皮冠状动脉介入治疗(PCI)中,药物涂层球囊(DCB)已被证明是改善小血管疾病患者临床结局的一种有前景的策略。在真实世界环境中,这种策略用于初发冠状动脉病变PCI的证据有限。本研究的目的是比较两种紫杉醇涂层球囊系统治疗所有初发冠状动脉病变的12个月结局。
纳入2014年1月至2018年12月在单一中心接受SeQuent Please或In.Pact Falcon DCB治疗初发冠状动脉狭窄的所有患者。主要终点是12个月时的心源性死亡、非致死性心肌梗死和靶血管血运重建的复合终点(3点主要不良心血管事件)。
共有496例患者的623处病变纳入研究,其中144处病变接受SeQuent Please治疗,352处病变接受In.Pact Falcon治疗。两组间基线患者、病变和手术特征相似。在12个月随访时,3点主要不良心血管事件结局相似(分别为4.2%和2.3%;P = 0.272)。心血管事件导致的死亡很少,且两组间相似(分别为2.7%和1.1%;P = 0.20)。
两种紫杉醇DCB系统具有相似的疗效和安全性结局,提示两者可能都是初发病变患者的合适治疗选择。然而,需要更大规模的随机对照研究来证实这些发现。