作者
Hyun Sung Joh,Woochan Kwon,Doosup Shin,Seung Hun Lee,Young Joon Hong,Dong-Hyun Hong,Sang Yoon Lee,Hanbit Park,Sunwon Kim,Sang Yeub Lee,Jin‐Sin Koh,Hangyul Kim,Chan Joon Kim,Eun Ho Choo,Hyuck‐Jun Yoon,Sang‐Don Park,Ki‐Hyun Jeon,Jang‐Whan Bae,Sung Gyun Ahn,Sung Eun Kim,Ki Hong Choi,Taek Kyu Park,Jeong Hoon Yang,Young Bin Song,Joo‐Yong Hahn,Seung‐Hyuk Choi,Hyeon‐Cheol Gwon,Joo Myung Lee
摘要
There are limited clinical data on drug-coated balloon (DCB)-based percutaneous coronary intervention (PCI) compared with drug-eluting stent (DES)-only PCI in patients with complex coronary artery lesions. The goal of the current study was to investigate the efficacy of DCB in patients undergoing PCI for complex coronary artery lesions. From an institutional registry of patients with de novo complex coronary artery lesions, 126 patients treated with DCB-based PCI were compared with 234 propensity score–matched patients treated with DES-only PCI. Complex coronary artery lesions were defined as the presence of at least 1 of the following: bifurcation, chronic total occlusion, unprotected left main disease, long lesion ≥38 mm, multivessel disease, lesion requiring ≥3 devices, or severe calcification. The primary endpoint was target vessel failure (TVF) at 2 years, a composite of cardiac death, target vessel–related myocardial infarction, and target vessel revascularization. Baseline characteristics were comparable between the 2 groups. DCB-based PCI showed a comparable risk of TVF vs DES-based PCI (7.6% vs 8.1%; HR: 0.81; 95% CI: 0.33-1.99; P = 0.638). The risks of cardiac death (5.0% vs 5.7%; HR: 0.78; 95% CI: 0.24-2.49), target vessel–related myocardial infarction (0.9% vs 1.3%; HR: 2.65; 95% CI: 0.26-27.06), and target vessel revascularization (3.5% vs 2.0%; HR: 1.30; 95% CI: 0.30-5.67) were also comparable between the 2 groups. DCB-based PCI showed comparable risks of TVF vs those of DES-only PCI in patients with complex coronary artery lesions. DCB might be considered as a suitable alternative device to DES in patients undergoing complex PCI. (Long-term Outcomes and Prognostic Factors in Patient Undergoing CABG or PCI; NCT03870815)