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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Main Authors: 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
Format: Article
Language:English
Published: BMC 2023-05-01
Series:Cardiovascular Diabetology
Subjects:
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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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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