Drug-coated balloons for the treatment of ostial left anterior descending or ostial left circumflex artery lesions:a patient-level propensity score-matched analysis
Liang PAN1
Wen-Jie LU1
Zhan-Ying HAN1
San-Cong PAN2
Xi WANG1
Ying-Guang SHAN1
Meng PENG1
Xiao-Fei QIN1
Guo-Ju SUN1
Pei-Sheng ZHANG3
Jian-Zeng DONG1
Chun-Guang QIU1
1.Department of Cardiovascular Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,China2.Department of Cardiology,Jincheng People's Hospital,Jincheng,China3.Department of Cardiology,the Fifth Affili-ated Hospital of Zhengzhou University,Zhengzhou,China
摘要：BACKGROUND Controversy exists as to the optimal treatment approach for ostial left anterior descending(LAD)or ostial left circumflex artery(LCx)lesions.Drug-coated balloons(DCB)may overcome some of the limitations of drug-eluting stents(DES).Therefore,we investigated the security and feasibility of the DCB policy in patients with ostial LAD or ostial LCx lesions,and compared it with the conventional DES-only strategy.
METHODS We retrospectively enrolled patients with de novo ostial lesions in the LAD or LCx who underwent interventional treatment.They were categorized into two groups based on their treatment approach:the DCB group and the DES group.The tre-atment strategies in the DCB group involved the use of either DCB-only or hybrid strategies,whereas the DES group utilized cro-ssover or precise stenting techniques.Two-year target lesion revascularization was the primary endpoint,while the rates of major adverse cardiovascular events,cardiac death,target vessel myocardial infarction,and vessel thrombosis were the secondary end-points.Using propensity score matching,we assembled a cohort with comparable baseline characteristics.To ensure result ana-lysis reliability,we conducted sensitivity analyses,including interaction,and stratified analyses.
RESULTS Among the 397 eligible patients,6.25％of patients who were planned to undergo DCB underwent DES.A total of 108 patients in each group had comparable propensity scores and were included in the analysis.Two-year target lesion revasculariza-tion occurred in 5 patients(4.90％)and 16 patients(16.33％)in the DCB group and the DES group,respectively(odds ratio=0.264,95％CI:0.093-0.752,P=0.008).Compared with the DES group,the DCB group demonstrated a lower major adverse cardiovascu-lar events rate(7.84％vs.19.39％,P=0.017).However,differences with regard to cardiac death,non-periprocedural target vessel myocardial infarction,and definite or probable vessel thrombosis between the groups were non-significant.
CONCLUSIONS The utilization of the DCB approach signifies an innovative and discretionary strategy for managing isolated ostial lesions in the LAD or LCx.Nevertheless,a future randomized trial investigating the feasibility and safety of DCB comp-ared to the DES-only strategy specifically for de novo ostial lesions in the LAD or LCx is highly warranted.
机标关键词：analysisanteriorarteryballoonscircumflexdescendingdrug-coatedleft
论文发表日期：2023-10-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：12( 716-727 )