Background Data on drug-coated balloon(DCB)treatment in elderly patients are limited.This study was to evaluate the efficacy of DCB treatment in percutaneous coronary intervention(PCI)among elderly patients.Methods A ...Background Data on drug-coated balloon(DCB)treatment in elderly patients are limited.This study was to evaluate the efficacy of DCB treatment in percutaneous coronary intervention(PCI)among elderly patients.Methods A retrospective analysis included 232 patients aged 75 years or older with coronary artery disease who underwent successful PCI using either DCB alone or in combination with drug-eluting stent(DES)based on pre-dilation results(DCB-based PCI).These patients were compared with 1818 elderly patients who underwent second-generation DES implantation(DES-only PCI).The endpoint was major adverse cardiovascular events(MACE)at 2-year follow-up.Results In the DCB-based PCI,61.2%of patients received DCB-only treatment.Compared to DES-only PCI,the DCB-based PCI group had fewer stents(0.5±0.7 and 1.7±0.8,P<0.001),shorter stent lengths(13.3±20.9 mm and 37.4±23.0 mm,P<0.001),and lower usage of small stents with a diameter of 2.5 mm or less(15.6%and 28.7%,P=0.010).The DCB-based PCI group exhibited lower rate of MACE(5.5%and 13.1%,P=0.003),target vessel revascularization(1.1%and 5.6%,P=0.017)and major bleeding(0.7%and 5.1%,P=0.009)at 2-year follow-up.The reduced risk in 2-year MACE was consistently observed across various matching procedures,with the most significant reduction noted in target vessel revascularization and major bleeding.Conclusion The DCB-based PCI reduced stent burden,particularly in the usage of small diameter stents,and was associated with lower risks of MACE,target vessel revascularization,and major bleeding compared to DES-only PCI in elderly patients.展开更多
Background Because limited comparative data are available,we decided to compare 2-year major clinical outcomes between beta-blockers (BB) with angiotensin converting enzyme inhibitors (ACEI) and BB with angiotensin re...Background Because limited comparative data are available,we decided to compare 2-year major clinical outcomes between beta-blockers (BB) with angiotensin converting enzyme inhibitors (ACEI) and BB with angiotensin receptor blockers (ARB) therapy in patients with non-ST-segment elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).Methods A total 11,288 NSTEMI patients who underwent PCI with DES were enrolled and they were divided into two groups,the BB with ACEI group (n = 7600) and the BB with ARB group (n = 3688).The major clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death,recurrent myocardial infarction (re-MI),total revascularization [target lesion revascularization (TLR),target vessel revascularization (TVR),non-TVR] rate during the 2-year follow-up period.Results After propensity score-matched (PSM) analysis,two PSM groups (3317 pairs,n = 6634,C-statistic = 0.695) were generated.Although the cumulative incidences of all-cause death,cardiac death,TLR,and non-TVR were similar between the two groups,MACE (HR = 0.832,95% CI: 0.704?0.982,P = 0.030),total revascularization rate (HR = 0.767,95% CI: 0.598?0.984,P = 0.037),and TVR rate (HR = 0.646,95% CI: 0.470?0.888,P = 0.007) were significantly lower in the BB with ACEI group after PSM.Conclusions In this study,we suggest that the combination of BB with ACEI may be beneficial for reducing the cumulative incidences of MACE,total revascularization rate,and TVR rather than the BB with ARB after PCI with DES in NSTEMI patients.展开更多
It is well known that the increase of necrotic core in previous atherosclerotic coronary artery disease is one of the conditions of vulnerable plaque. However, it is not known how fast necrotic core could decrease in ...It is well known that the increase of necrotic core in previous atherosclerotic coronary artery disease is one of the conditions of vulnerable plaque. However, it is not known how fast necrotic core could decrease in a vulnerable plaque. We had 2 patients who had suffered from acute myocardial infarction and had large amount of necrotic core in their culprit lesions at baseline, which decreased markedly within 7 days. Also, they were clinically stable and asymptomatic over 1 year follow-up. It is first report to show mar-kedly decrease of necrotic core amount within only 7 days in culprit lesions of 2 cases of acute myocardial infarction with angiographically minimal lesions.展开更多
文摘Background Data on drug-coated balloon(DCB)treatment in elderly patients are limited.This study was to evaluate the efficacy of DCB treatment in percutaneous coronary intervention(PCI)among elderly patients.Methods A retrospective analysis included 232 patients aged 75 years or older with coronary artery disease who underwent successful PCI using either DCB alone or in combination with drug-eluting stent(DES)based on pre-dilation results(DCB-based PCI).These patients were compared with 1818 elderly patients who underwent second-generation DES implantation(DES-only PCI).The endpoint was major adverse cardiovascular events(MACE)at 2-year follow-up.Results In the DCB-based PCI,61.2%of patients received DCB-only treatment.Compared to DES-only PCI,the DCB-based PCI group had fewer stents(0.5±0.7 and 1.7±0.8,P<0.001),shorter stent lengths(13.3±20.9 mm and 37.4±23.0 mm,P<0.001),and lower usage of small stents with a diameter of 2.5 mm or less(15.6%and 28.7%,P=0.010).The DCB-based PCI group exhibited lower rate of MACE(5.5%and 13.1%,P=0.003),target vessel revascularization(1.1%and 5.6%,P=0.017)and major bleeding(0.7%and 5.1%,P=0.009)at 2-year follow-up.The reduced risk in 2-year MACE was consistently observed across various matching procedures,with the most significant reduction noted in target vessel revascularization and major bleeding.Conclusion The DCB-based PCI reduced stent burden,particularly in the usage of small diameter stents,and was associated with lower risks of MACE,target vessel revascularization,and major bleeding compared to DES-only PCI in elderly patients.
基金supported by Research of Korea Centers for Disease Control and Prevention (2016-ER6304-02)
文摘Background Because limited comparative data are available,we decided to compare 2-year major clinical outcomes between beta-blockers (BB) with angiotensin converting enzyme inhibitors (ACEI) and BB with angiotensin receptor blockers (ARB) therapy in patients with non-ST-segment elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).Methods A total 11,288 NSTEMI patients who underwent PCI with DES were enrolled and they were divided into two groups,the BB with ACEI group (n = 7600) and the BB with ARB group (n = 3688).The major clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death,recurrent myocardial infarction (re-MI),total revascularization [target lesion revascularization (TLR),target vessel revascularization (TVR),non-TVR] rate during the 2-year follow-up period.Results After propensity score-matched (PSM) analysis,two PSM groups (3317 pairs,n = 6634,C-statistic = 0.695) were generated.Although the cumulative incidences of all-cause death,cardiac death,TLR,and non-TVR were similar between the two groups,MACE (HR = 0.832,95% CI: 0.704?0.982,P = 0.030),total revascularization rate (HR = 0.767,95% CI: 0.598?0.984,P = 0.037),and TVR rate (HR = 0.646,95% CI: 0.470?0.888,P = 0.007) were significantly lower in the BB with ACEI group after PSM.Conclusions In this study,we suggest that the combination of BB with ACEI may be beneficial for reducing the cumulative incidences of MACE,total revascularization rate,and TVR rather than the BB with ARB after PCI with DES in NSTEMI patients.
文摘It is well known that the increase of necrotic core in previous atherosclerotic coronary artery disease is one of the conditions of vulnerable plaque. However, it is not known how fast necrotic core could decrease in a vulnerable plaque. We had 2 patients who had suffered from acute myocardial infarction and had large amount of necrotic core in their culprit lesions at baseline, which decreased markedly within 7 days. Also, they were clinically stable and asymptomatic over 1 year follow-up. It is first report to show mar-kedly decrease of necrotic core amount within only 7 days in culprit lesions of 2 cases of acute myocardial infarction with angiographically minimal lesions.
