Teo Jassie, Noor Tawfeq Mohd, Ahmad Nor Faiqah, Zainal Zulaikha, Wong Steven, Thum Chan Ho, Aris Faten Aqilah, Teh Khai Chih, Palaniappan Ganapathi, Koh Hui Beng, Roslan Aslannif, Rusani Beni, Ganesan Kumara, Hadi Hafidz
Cardiology Department, National Heart Institute (Institut Jantung), Kuala Lumpur, Malaysia.
Clinical Research Department, National Heart Institute (Institut Jantung), Kuala Lumpur, Malaysia.
AsiaIntervention. 2024 Sep 27;10(3):212-218. doi: 10.4244/AIJ-D-23-00066. eCollection 2024 Sep.
The hybrid strategy of drug-eluting stent (DES) and drug-coated balloon (DCB) has been increasingly accepted for the treatment of coronary artery disease. However, data regarding the clinical outcome of this practice in a Southeast Asian population are limited.
We aimed to investigate the safety and clinical outcome of this hybrid strategy (DES and DCB) in the treatment of coronary artery disease. The primary endpoint was target lesion failure (TLF) in the DES/DCB-treated segment at 12 months. TLF is defined as the composite of cardiac death, target vessel myocardial infarction (TVMI) and ischaemia-driven target lesion revascularisation (ID-TLR) in the DES- and/or DCB-treated segment.
A total of 401 patients with 458 lesions were treated with the hybrid strategy at the National Heart Institute (IJN), Kuala Lumpur, Malaysia, from 1 July 2021 to 30 June 2022, were retrospectively enrolled in the study. A total of 38 patients (9.5%) were lost to subsequent follow-up, and the remaining 363 patients (90.5%) were included in the outcome analysis. Clinical outcomes at 1 year were analysed.
In all, 219 lesions (47.8%) involved the left anterior descending artery, 146 lesions (31.9%) involved the right coronary artery, and 57 lesions (12.4%) involved the left circumflex artery. In all, 87 lesions (19%) were bifurcation lesions. A total of 8 patients (2.2%) had TLF, of whom 3 patients (0.83%) had TVMI, 3 patients (0.83%) had ID-TLR, and 2 patients (0.6%) experienced cardiac death. Four patients died of a non-cardiac cause at 1-year follow-up.
A hybrid strategy of DES and DCB for the treatment of coronary artery lesions appears to be feasible and clinically safe according to the 1-year outcomes.
药物洗脱支架（DES）和药物涂层球囊（DCB）的联合策略在冠状动脉疾病治疗中越来越被接受。然而，关于这种治疗方法在东南亚人群中的临床结果的数据有限。
我们旨在研究这种联合策略（DES和DCB）治疗冠状动脉疾病的安全性和临床结果。主要终点是12个月时DES/DCB治疗节段的靶病变失败（TLF）。TLF定义为DES和/或DCB治疗节段中心脏死亡、靶血管心肌梗死（TVMI）和缺血驱动的靶病变血运重建（ID-TLR）的复合情况。
回顾性纳入2021年7月1日至2022年6月30日在马来西亚吉隆坡国家心脏研究所（IJN）接受联合策略治疗的401例患者的458个病变。共有38例患者（9.5%）失访，其余363例患者（90.5%）纳入结局分析。分析1年时的临床结局。
总共219个病变（47.8%）累及左前降支，146个病变（31.9%）累及右冠状动脉，57个病变（12.4%）累及左旋支。总共87个病变（19%）为分叉病变。共有8例患者（2.2%）发生TLF，其中3例患者（0.83%）发生TVMI，3例患者（0.83%）发生ID-TLR，2例患者（0.6%）发生心脏死亡。4例患者在1年随访时死于非心脏原因。
根据1年的结果，DES和DCB联合策略治疗冠状动脉病变似乎是可行的且临床安全。
