Angiographic residual stenosis and clinical outcomes after elective drug-coated balloon angioplasty for de novo coronary lesions: a single center retrospective study.
Source: PubMed, NCBI / U.S. National Library of Medicine
Drug-coated balloon (DCB) Academic Research Consortium (ARC) defined post-procedural percent diameter stenoses (final %DSs) of 40 and 20 as the thresholds of successful DCB angioplasty and drug-eluting stent (DES) placement, respectively. The present single-center, retrospective, lesion-based study clarified the clinically relevant final %DS threshold by including consecutive 297 de novo lesions in 250 patients after successful DCB angioplasty between January 2016 and March 2022, irrespective of vessel size. The whole lesions were stratified into 2 groups of final %DS below 20 (n = 168) and final %DS between 20 and 40 (n = 129). Cumulative 2-year target vessel failure (TVF), comprising of cardiac mortality, non-fatal myocardial infarction, and target vessel revascularization, in final %DS between 20 and 40 group (14.0% with mean observational interval of 629 ± 199 days) was significantly higher than that in final %DS below 20 group (6.5%, 649 ± 168 days, p = 0.033). Final %DS between 20 and 40 was one of the predictors of cumulative 2-year TVF by multiple Cox proportional hazard model (hazard ratio: 2.29, 95% confidence interval: 1.04-5.00, p = 0.039), besides with congestive heart failure and bending lesion. Lesions of calcification, smaller and longer DCB used were the predictors of final %DS between 20 and 40 by multiple logistic regression analysis. Thus, we postulated
Abstract
Drug-coated balloon (DCB) Academic Research Consortium (ARC) defined post-procedural percent diameter stenoses (final %DSs) of 40 and 20 as the thresholds of successful DCB angioplasty and drug-eluting stent (DES) placement, respectively. The present single-center, retrospective, lesion-based study clarified the clinically relevant final %DS threshold by including consecutive 297 de novo lesions in 250 patients after successful DCB angioplasty between January 2016 and March 2022, irrespective of vessel size. The whole lesions were stratified into 2 groups of final %DS below 20 (n = 168) and final %DS between 20 and 40 (n = 129). Cumulative 2-year target vessel failure (TVF), comprising of cardiac mortality, non-fatal myocardial infarction, and target vessel revascularization, in final %DS between 20 and 40 group (14.0% with mean observational interval of 629 ± 199 days) was significantly higher than that in final %DS below 20 group (6.5%, 649 ± 168 days, p = 0.033). Final %DS between 20 and 40 was one of the predictors of cumulative 2-year TVF by multiple Cox proportional hazard model (hazard ratio: 2.29, 95% confidence interval: 1.04-5.00, p = 0.039), besides with congestive heart failure and bending lesion. Lesions of calcification, smaller and longer DCB used were the predictors of final %DS between 20 and 40 by multiple logistic regression analysis. Thus, we postulated final %DS of 20 as a candidate of clinically relevant cutoff value of angiographic endpoint associated with favorable outcomes after elective DCB angioplasty for de novo lesions, in response to latest international DCB ARC statement.