| Autor: |
Guillaume Marquis-Gravel, Alexis Matteau, Brian J Potter, François Gobeil, Nicolas Noiseux, Louis-Mathieu Stevens, Samer Mansour |
| Jazyk: |
English<br />Portuguese |
| Rok vydání: |
2017 |
| Předmět: |
|
| Zdroj: |
Arquivos Brasileiros de Cardiologia, Vol 109, Iss 4, Pp 277-283 (2017) |
| Druh dokumentu: |
article |
| ISSN: |
1678-4170 |
| DOI: |
10.5935/abc.20170142 |
| Popis: |
Abstract Background: The place of drug-eluting balloons (DEB) in the treatment of in-stent restenosis (ISR) is not well-defined, particularly in a population of all-comers with acute coronary syndromes (ACS). Objective: Compare the clinical outcomes of DEB with second-generation drug-eluting stents (DES) for the treatment of ISR in a real-world population with a high proportion of ACS. Methods: A retrospective analysis of consecutive patients with ISR treated with a DEB compared to patients treated with a second-generation DES was performed. The primary endpoint was a composite of major adverse cardiovascular events (MACE: all-cause death, non-fatal myocardial infarction, and target lesion revascularization). Comparisons were performed using Cox proportional hazards multivariate adjustment and Kaplan-Meier analysis with log-rank. Results: The cohort included 91 patients treated with a DEB and 89 patients treated with a DES (74% ACS). Median follow-up was 26 months. MACE occurred in 33 patients (36%) in the DEB group, compared to 17 patients (19%) in the DES group (p log-rank = 0.02). After multivariate adjustment, there was no significant difference between the groups (HR for DEB = 1.45 [95%CI: 0.75-2.83]; p = 0.27). Mortality rates at 1 year were 11% with DEB, and 3% with DES (p = 0.04; adjusted HR = 2.85 [95%CI: 0.98-8.32]; p = 0.06). Conclusion: In a population with a high proportion of ACS, a non-significant numerical signal towards increased rates of MACE with DEB compared to second-generation DES for the treatment of ISR was observed, mainly driven by a higher mortality rate. An adequately-powered randomized controlled trial is necessary to confirm these findings. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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