Long-Term Outcomes Following Drug-Eluting Balloons Versus Thin-Strut Drug-Eluting Stents for Treatment of In-Stent Restenosis (DEB-Dragon-Registry)

被引：22

作者：

Wanha, Wojciech ^{[1
]}

Bil, Jacek ^{[2
]}

Januszek, Rafal ^{[3
,4
]}

Gilis-Malinowska, Natasza ^{[5
]}

Figatowski, Tomasz ^{[5
]}

Milewski, Marek ^{[1
]}

Pawlik, Artur ^{[3
]}

Staszczak, Bartlomiej ^{[3
]}

Wybraniec, Maciej ^{[6
]}

Tomasiewicz, Brunon ^{[7
]}

Kubler, Piotr ^{[7
]}

Kuliczkowski, Wiktor ^{[7
]}

Walczak, Tomasz ^{[8
]}

Hrymniak, Bruno ^{[8
]}

Desperak, Piotr ^{[9
]}

Mielczarek, Maksymilian ^{[5
]}

Ciecwierz, Dariusz ^{[5
]}

Niezgoda, Piotr ^{[10
]}

Wolny, Rafal ^{[11
]}

Chudzik, Magdalena ^{[12
]}

Kuzma, Lukasz ^{[13
]}

Kralisz, Pawel ^{[13
]}

Kedhi, Elvin ^{[1
,14
]}

D'Ascenzo, Fabrizio ^{[15
]}

Hudziak, Damian ^{[16
]}

Kowalowka, Adam ^{[16
]}

Smolka, Grzegorz ^{[1
]}

Reczuch, Krzysztof ^{[7
]}

Gruchala, Marcin ^{[5
]}

Kubica, Jacek ^{[10
]}

Gil, Robert J. ^{[2
]}

Dobrzycki, Slawomir ^{[13
]}

Dudek, Dariusz ^{[3
]}

Bartu, Stanislaw ^{[3
]}

Gasior, Mariusz ^{[9
]}

Ochala, Andrzej ^{[1
]}

Witkowski, Adam ^{[11
]}

Jaguszewski, Milosz ^{[5
]}

Wojakowski, Wojciech ^{[1
]}

机构：

[1] Med Univ Silesia, Dept Cardiol & Struct Heart Dis, Ziolowa 45, PL-40635 Katowice, Poland

[2] Ctr Postgrad Med Educ, Dept Invas Cardiol, Warsaw, Poland

[3] Jagiellonian Univ Med Coll, Dept Cardiol, Krakow, Poland

[4] Univ Phys Educ, Dept Clin Rehabil, Krakow, Poland

[5] Med Univ Gdansk, Dept Cardiol 1, Gdansk, Poland

[6] Med Univ Silesia, Sch Med Katowice, Dept Cardiol 1, Katowice, Poland

[7] Wroclaw Med Univ, Dept Heart Dis, Univ Hosp Wroclaw, Ctr Heart Dis, Wroclaw, Poland

[8] 4th Mil Hosp, Dept Cardiol, Wroclaw, Poland

[9] Med Univ Silesia, Dept Cardiol 3, Zabrze, Poland

[10] Nicolaus Copernicus Univ, Coll Med, Dept Cardiol & Internal Med, Bydgoszcz, Poland

[11] Natl Inst Cardiol, Dept Intervent Cardiol & Angiol, Warsaw, Poland

[12] Med Univ Warsaw, Warsaw, Poland

[13] Med Univ Bialystok, Dept Invas Cardiol, Bialystok, Poland

[14] AZ Sint Jan Brugge, Brugge, Belgium

[15] Univ Turin, Citta Salute & Sci, Dept Internal Med, Div Cardiol, Turin, Italy

[16] Med Univ Silesia, Dept Cardiac Surg, Katowice, Poland

来源：

CIRCULATION-CARDIOVASCULAR INTERVENTIONS | 2021年 / 14卷 / 09期

关键词：

drug-eluting stent; drug-eluting balloon; in-stent restenosis; PACLITAXEL-COATED BALLOON; CORONARY-ARTERIES; RANDOMIZED-TRIAL; ANGIOPLASTY;

D O I：

10.1161/CIRCINTERVENTIONS.121.010868

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND: Data regarding the use of percutaneous coronary intervention with drug-eluting balloons (DEB) versus thin-strut drug-eluting stents (thin-DES) for treating DES in-stent restenosis in everyday clinical practice is scarce. Our goal was to evaluate the efficacy and safety profile of DEB versus thin-DES in DES in-stent restenosis. METHODS: Consecutive patients with DES in-stent restenosis who underwent percutaneous coronary intervention between 2008 and 2019 entered the multicenter DEB-DRAGON Registry with a follow-up of 3 years. Patients who received DEB at the index procedure (n=557, 49.9%) were compared with those who received thin-DES (n=560, 50.1%). RESULTS: Analysis of the unmatched cohort revealed lower rates of target lesion revascularization (9.1% versus 13.6%; hazard ratio [HR], 0.58 [95% CI, 0.41-0.83], P=0.003), target vessel revascularization (11.8% versus 16.7%; HR, 0.62 [95% CI, 0.45-0.84], P=0.003) and device-oriented composite end point, defined as a composite of cardiac death, target lesion revascularization, and target vessel myocardial infarction (12.7% versus 16.0%; HR, 0.69 [95% CI, 0.50-0.94], P=0.018) in the thin-DES group compared with the DEB group. The incidence of cardiac death, target vessel-myocardial infarction, and myocardial infarction were similar in both groups. However, after propensity score matching, there were no significant differences in target lesion revascularization (11.2% versus 11.2%; HR, 0.91 [95% CI, 0.55-1.51], P=0.707), target vessel revascularization (13.4% versus 14.2%; HR, 0.86 [95% CI, 0.55-1.36], P=0.523), and device-oriented composite end point (14.2% versus 14.2%; HR, 0.91 [95% CI, 0.58-1.42], P=0.667) between the thin-DES and DEB group, respectively. CONCLUSIONS: This analysis of a real-life registry revealed similar long-term outcomes of thin-DES and DEB in DES in-stent restenosis regarding target lesion revascularization, myocardial infarction, cardiac death, and device-oriented composite end point.

引用

页数：9

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