AI Article Synopsis
- Balloon angioplasty with drug-coated balloons (DCBs) is commonly used for treating in-stent restenosis, but its long-term effectiveness was not well studied until this investigation.
- The study analyzed data from over 9,000 patients to compare DCBs, drug-eluting stents, and traditional balloon angioplasty over a 5-year period, focusing on outcomes like target-lesion revascularization and death rates.
- Results showed that DCB angioplasty led to fewer revascularization procedures and lower overall and cardiovascular death rates compared to traditional balloon angioplasty, but it was less effective than drug-eluting stents in preventing repeat procedures.
Article Abstract
Background: Balloon angioplasty with drug-coated balloons (DCBs) is frequently used during percutaneous coronary intervention for in-stent restenosis. Despite its frequent use, there is a lack of long-term data on the efficacy of DCB angioplasty. We conducted an investigation on the long-term efficacy outcome of in-stent restenosis, comparing DCBs, drug-eluting stents, and plain old balloon angioplasty.
Methods And Results: We conducted a nationwide analysis from the SCAAR (Swedish Coronary Angiography and Angioplasty Registry) including in-stent restenosis lesions undergoing coronary angiography between June 11, 2013, and January 14, 2022. The primary outcome of this study was target-lesion revascularization within a 5-year follow-up. Secondary outcomes included all-cause death, cardiovascular death, myocardial infarction, and any percutaneous coronary intervention. The outcomes were analyzed using a multivariable Cox proportional hazard model or Poisson regression, as appropriate. A total of 10 561 lesions from 9062 patients were included. Compared with plain old balloon angioplasty, the use of DCB angioplasty was associated with less target-lesion revascularization (risk ratio, 0.69 [95% CI, 0.57-0.82]), all-cause death (risk ratio, 0.72 [95% CI, 0.59-0.88]), and cardiovascular death (hazard ratio [HR], 0.59 [95% CI, 0.45-0.78]). No difference was observed for myocardial infarction or any percutaneous coronary intervention. Compared with drug-eluting stents, the use of DCBs was associated with higher rates of target-lesion revascularization (HR, 1.20 [95% CI, 1.06-1.37]). No difference was observed for all-cause death, cardiovascular death, myocardial infarction, or any percutaneous coronary intervention.
Conclusions: In this long-term nationwide analysis, the use of DCB angioplasty showed superior outcomes compared with plain old balloon angioplasty within 5 years but higher rates of repeat revascularizations compared with drug-eluting stents.
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|---|---|
| http://dx.doi.org/10.1161/JAHA.124.036839 | DOI Listing |
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681599 | PMC |
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