Drug-coated balloon-based versus drug-eluting stent-only revascularization in patients with diabetes and multivessel coronary artery disease
Abstract Background Data on drug-coated balloon (DCB) treatment in the context of diabetes mellitus (DM) and multivessel coronary artery disease (CAD) are limited. We aimed to investigate the clinical impact of DCB-based revascularization on percutaneous coronary intervention (PCI) in patients with...
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BMC
2023-05-01
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Series: | Cardiovascular Diabetology |
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Online Access: | https://doi.org/10.1186/s12933-023-01853-0 |
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author | Ae-Young Her Eun-Seok Shin Sunwon Kim Bitna Kim Tae-Hyun Kim Chang-Bae Sohn Byung Joo Choi Yongwhi Park Jung Rae Cho Young-Hoon Jeong |
author_facet | Ae-Young Her Eun-Seok Shin Sunwon Kim Bitna Kim Tae-Hyun Kim Chang-Bae Sohn Byung Joo Choi Yongwhi Park Jung Rae Cho Young-Hoon Jeong |
author_sort | Ae-Young Her |
collection | DOAJ |
description | Abstract Background Data on drug-coated balloon (DCB) treatment in the context of diabetes mellitus (DM) and multivessel coronary artery disease (CAD) are limited. We aimed to investigate the clinical impact of DCB-based revascularization on percutaneous coronary intervention (PCI) in patients with DM and multivessel CAD. Methods A total of 254 patients with multivessel disease (104 patients with DM) successfully treated with DCB alone or combined with drug-eluting stent (DES) were retrospectively enrolled (DCB-based group) and compared with 254 propensity-matched patients treated with second-generation DES from the PTRG-DES registry (n = 13,160 patients) (DES-only group). Major adverse cardiovascular events (MACE) comprised cardiac death, myocardial infarction, stroke, stent or target lesion thrombosis, target vessel revascularization, and major bleeding at 2 years. Results The DCB-based group was associated with a reduced risk of MACE in patients with DM (hazard ratio [HR] 0.19, 95% confidence interval [CI] 0.05–0.68, p = 0.003], but not in those without DM (HR 0.52, 95% CI 0.20–1.38, p = 0.167) at the 2-year follow-up. In patients with DM, the risk of cardiac death was lower in the DCB-based group than the DES-only group, but not in those without DM. In both patients with or without DM, the burdens of DES and small DES (less than 2.5 mm) used were lower in the DCB-based group than in the DES-only group. Conclusions In multivessel CAD, the clinical benefit of a DCB-based revascularization strategy appears to be more evident in patients with DM than in those without DM after 2 years of follow-up. (Impact of Drug-Coated Balloon Treatment in De Novo Coronary Lesion; NCT04619277) |
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id | doaj.art-66d1a86a2e394006be433bc08b90a9ef |
institution | Directory Open Access Journal |
issn | 1475-2840 |
language | English |
last_indexed | 2024-03-13T10:17:58Z |
publishDate | 2023-05-01 |
publisher | BMC |
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series | Cardiovascular Diabetology |
spelling | doaj.art-66d1a86a2e394006be433bc08b90a9ef2023-05-21T11:07:34ZengBMCCardiovascular Diabetology1475-28402023-05-012211810.1186/s12933-023-01853-0Drug-coated balloon-based versus drug-eluting stent-only revascularization in patients with diabetes and multivessel coronary artery diseaseAe-Young Her0Eun-Seok Shin1Sunwon Kim2Bitna Kim3Tae-Hyun Kim4Chang-Bae Sohn5Byung Joo Choi6Yongwhi Park7Jung Rae Cho8Young-Hoon Jeong9Division of Cardiology, Department of Internal Medicine, Kangwon National University College of Medicine, Kangwon National University School of MedicineDepartment of Cardiology, Ulsan University Hospital, University of Ulsan College of MedicineDepartment of Cardiology, Korea University Ansan HospitalDepartment of Cardiology, Ulsan University Hospital, University of Ulsan College of MedicineDepartment of Cardiology, Ulsan Medical CenterDepartment of Cardiology, Ulsan Medical CenterDepartment of Cardiology, Ulsan Medical CenterDepartment of Internal Medicine, Cardiovascular Center, Gyeongsang National University School of MedicineCardiology Division, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of MedicineDivision of Cardiology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of MedicineAbstract Background Data on drug-coated balloon (DCB) treatment in the context of diabetes mellitus (DM) and multivessel coronary artery disease (CAD) are limited. We aimed to investigate the clinical impact of DCB-based revascularization on percutaneous coronary intervention (PCI) in patients with DM and multivessel CAD. Methods A total of 254 patients with multivessel disease (104 patients with DM) successfully treated with DCB alone or combined with drug-eluting stent (DES) were retrospectively enrolled (DCB-based group) and compared with 254 propensity-matched patients treated with second-generation DES from the PTRG-DES registry (n = 13,160 patients) (DES-only group). Major adverse cardiovascular events (MACE) comprised cardiac death, myocardial infarction, stroke, stent or target lesion thrombosis, target vessel revascularization, and major bleeding at 2 years. Results The DCB-based group was associated with a reduced risk of MACE in patients with DM (hazard ratio [HR] 0.19, 95% confidence interval [CI] 0.05–0.68, p = 0.003], but not in those without DM (HR 0.52, 95% CI 0.20–1.38, p = 0.167) at the 2-year follow-up. In patients with DM, the risk of cardiac death was lower in the DCB-based group than the DES-only group, but not in those without DM. In both patients with or without DM, the burdens of DES and small DES (less than 2.5 mm) used were lower in the DCB-based group than in the DES-only group. Conclusions In multivessel CAD, the clinical benefit of a DCB-based revascularization strategy appears to be more evident in patients with DM than in those without DM after 2 years of follow-up. (Impact of Drug-Coated Balloon Treatment in De Novo Coronary Lesion; NCT04619277)https://doi.org/10.1186/s12933-023-01853-0Diabetes mellitusMultivesselDrug-coated balloonDrug-eluting stentCoronary artery diseasePercutaneous coronary intervention |
spellingShingle | Ae-Young Her Eun-Seok Shin Sunwon Kim Bitna Kim Tae-Hyun Kim Chang-Bae Sohn Byung Joo Choi Yongwhi Park Jung Rae Cho Young-Hoon Jeong Drug-coated balloon-based versus drug-eluting stent-only revascularization in patients with diabetes and multivessel coronary artery disease Cardiovascular Diabetology Diabetes mellitus Multivessel Drug-coated balloon Drug-eluting stent Coronary artery disease Percutaneous coronary intervention |
title | Drug-coated balloon-based versus drug-eluting stent-only revascularization in patients with diabetes and multivessel coronary artery disease |
title_full | Drug-coated balloon-based versus drug-eluting stent-only revascularization in patients with diabetes and multivessel coronary artery disease |
title_fullStr | Drug-coated balloon-based versus drug-eluting stent-only revascularization in patients with diabetes and multivessel coronary artery disease |
title_full_unstemmed | Drug-coated balloon-based versus drug-eluting stent-only revascularization in patients with diabetes and multivessel coronary artery disease |
title_short | Drug-coated balloon-based versus drug-eluting stent-only revascularization in patients with diabetes and multivessel coronary artery disease |
title_sort | drug coated balloon based versus drug eluting stent only revascularization in patients with diabetes and multivessel coronary artery disease |
topic | Diabetes mellitus Multivessel Drug-coated balloon Drug-eluting stent Coronary artery disease Percutaneous coronary intervention |
url | https://doi.org/10.1186/s12933-023-01853-0 |
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