Drug‐eluting stent and drug‐coated balloon for the treatment of de novo diffuse coronary artery disease lesions: A retrospective case series study
Background The hybrid strategy of a combination of drug‐eluting stent (DES) and drug‐coated balloon (DCB) is promising for the treatment of de novo diffuse coronary artery disease (CAD). Hypothesis To investigate the efficacy and functional results of hybrid strategy. Methods This case series study...
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Published in | Clinical cardiology (Mahwah, N.J.) Vol. 46; no. 12; pp. 1511 - 1518 |
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Main Authors | , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
John Wiley & Sons, Inc
01.12.2023
John Wiley and Sons Inc |
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Abstract | Background
The hybrid strategy of a combination of drug‐eluting stent (DES) and drug‐coated balloon (DCB) is promising for the treatment of de novo diffuse coronary artery disease (CAD).
Hypothesis
To investigate the efficacy and functional results of hybrid strategy.
Methods
This case series study included patients treated with a hybrid approach for de novo diffuse CAD between February 2017 and November 2021. Postprocedural quantitative flow ratio (QFR) was used to evaluate the functional results. The primary endpoint was procedural success rate. The secondary endpoints were major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction (MI) (including peri‐procedural MI), and target vessel revascularization.
Results
A total of 109 patients with 114 lesions were treated. DES and DCB were commonly used in larger proximal segments and smaller distal segments, respectively. The mean QFR value was 0.9 ± 0.1 and 105 patients (96.3%) had values >0.8 in all the treated vessels. Procedural success was achieved in 106 (97.2%) patients. No cases of cardiac death were reported at a median follow‐up of 19 months. Spontaneous MI occurred in three (2.8%) patients and target vessel revascularization in six (5.5%) patients. Estimated 2‐year rate of MACE excluding peri‐procedural MI was higher in the group with lower QFR value (12.1 ± 5.7% vs. 5.6 ± 4.4%, log‐rank p = .035) (cut‐off value 0.9).
Conclusion
Hybrid strategy is a promising approach for the treatment of de novo diffuse CAD. Postprocedural QFR has some implications for prognosis and may be helpful in guiding this approach.
A hybrid strategy using DES and DCB showed encouraging performance and acceptable clinical outcomes for the treatment of de novo diffuse CAD. This approach also yielded promising functional results as evaluated by QFR. Higher post‐PCI QFR value was associated with better prognosis and might be helpful in guidance of this approach. |
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AbstractList | The hybrid strategy of a combination of drug-eluting stent (DES) and drug-coated balloon (DCB) is promising for the treatment of de novo diffuse coronary artery disease (CAD).
To investigate the efficacy and functional results of hybrid strategy.
This case series study included patients treated with a hybrid approach for de novo diffuse CAD between February 2017 and November 2021. Postprocedural quantitative flow ratio (QFR) was used to evaluate the functional results. The primary endpoint was procedural success rate. The secondary endpoints were major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction (MI) (including peri-procedural MI), and target vessel revascularization.
A total of 109 patients with 114 lesions were treated. DES and DCB were commonly used in larger proximal segments and smaller distal segments, respectively. The mean QFR value was 0.9 ± 0.1 and 105 patients (96.3%) had values >0.8 in all the treated vessels. Procedural success was achieved in 106 (97.2%) patients. No cases of cardiac death were reported at a median follow-up of 19 months. Spontaneous MI occurred in three (2.8%) patients and target vessel revascularization in six (5.5%) patients. Estimated 2-year rate of MACE excluding peri-procedural MI was higher in the group with lower QFR value (12.1 ± 5.7% vs. 5.6 ± 4.4%, log-rank p = .035) (cut-off value 0.9).
Hybrid strategy is a promising approach for the treatment of de novo diffuse CAD. Postprocedural QFR has some implications for prognosis and may be helpful in guiding this approach. Background The hybrid strategy of a combination of drug‐eluting stent (DES) and drug‐coated balloon (DCB) is promising for the treatment of de novo diffuse coronary artery disease (CAD). Hypothesis To investigate the efficacy and functional results of hybrid strategy. Methods This case series study included patients treated with a hybrid approach for de novo diffuse CAD between February 2017 and November 2021. Postprocedural quantitative flow ratio (QFR) was used to evaluate the functional results. The primary endpoint was procedural success rate. The secondary endpoints were major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction (MI) (including peri‐procedural MI), and target vessel revascularization. Results A total of 109 patients with 114 lesions were treated. DES and DCB were commonly used in larger proximal segments and smaller distal segments, respectively. The mean QFR value was 0.9 ± 0.1 and 105 patients (96.3%) had values >0.8 in all the treated vessels. Procedural success was achieved in 106 (97.2%) patients. No cases of cardiac death were reported at a median follow‐up of 19 months. Spontaneous MI occurred in three (2.8%) patients and target vessel revascularization in six (5.5%) patients. Estimated 2‐year rate of MACE excluding peri‐procedural MI was higher in the group with lower QFR value (12.1 ± 5.7% vs. 5.6 ± 4.4%, log‐rank p = .035) (cut‐off value 0.9). Conclusion Hybrid strategy is a promising approach for the treatment of de novo diffuse CAD. Postprocedural QFR has some implications for prognosis and may be helpful in guiding this approach. A hybrid strategy using DES and DCB showed encouraging performance and acceptable clinical outcomes for the treatment of de novo diffuse CAD. This approach also yielded promising functional results as evaluated by QFR. Higher post‐PCI QFR value was associated with better prognosis and might be helpful in guidance of this approach. Abstract Background The hybrid strategy of a combination of drug‐eluting stent (DES) and drug‐coated balloon (DCB) is promising for the treatment of de novo diffuse coronary artery disease (CAD). Hypothesis To investigate the efficacy and functional results of hybrid strategy. Methods This case series study included patients treated with a hybrid approach for de novo diffuse CAD between February 2017 and November 2021. Postprocedural quantitative flow ratio (QFR) was used to evaluate the functional results. The primary endpoint was procedural success rate. The secondary endpoints were major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction (MI) (including peri‐procedural MI), and target vessel revascularization. Results A total of 109 patients with 114 lesions were treated. DES and DCB were commonly used in larger proximal segments and smaller distal segments, respectively. The mean QFR value was 0.9 ± 0.1 and 105 patients (96.3%) had values >0.8 in all the treated vessels. Procedural success was achieved in 106 (97.2%) patients. No cases of cardiac death were reported at a median follow‐up of 19 months. Spontaneous MI occurred in three (2.8%) patients and target vessel revascularization in six (5.5%) patients. Estimated 2‐year rate of MACE excluding peri‐procedural MI was higher in the group with lower QFR value (12.1 ± 5.7% vs. 5.6 ± 4.4%, log‐rank p = .035) (cut‐off value 0.9). Conclusion Hybrid strategy is a promising approach for the treatment of de novo diffuse CAD. Postprocedural QFR has some implications for prognosis and may be helpful in guiding this approach. A hybrid strategy using DES and DCB showed encouraging performance and acceptable clinical outcomes for the treatment of de novo diffuse CAD. This approach also yielded promising functional results as evaluated by QFR. Higher post‐PCI QFR value was associated with better prognosis and might be helpful in guidance of this approach. BackgroundThe hybrid strategy of a combination of drug-eluting stent (DES) and drug-coated balloon (DCB) is promising for the treatment of de novo diffuse coronary artery disease (CAD).HypothesisTo investigate the efficacy and functional results of hybrid strategy.MethodsThis case series study included patients treated with a hybrid approach for de novo diffuse CAD between February 2017 and November 2021. Postprocedural quantitative flow ratio (QFR) was used to evaluate the functional results. The primary endpoint was procedural success rate. The secondary endpoints were major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction (MI) (including peri-procedural MI), and target vessel revascularization.ResultsA total of 109 patients with 114 lesions were treated. DES and DCB were commonly used in larger proximal segments and smaller distal segments, respectively. The mean QFR value was 0.9 ± 0.1 and 105 patients (96.3%) had values >0.8 in all the treated vessels. Procedural success was achieved in 106 (97.2%) patients. No cases of cardiac death were reported at a median follow-up of 19 months. Spontaneous MI occurred in three (2.8%) patients and target vessel revascularization in six (5.5%) patients. Estimated 2-year rate of MACE excluding peri-procedural MI was higher in the group with lower QFR value (12.1 ± 5.7% vs. 5.6 ± 4.4%, log-rank p = .035) (cut-off value 0.9).ConclusionHybrid strategy is a promising approach for the treatment of de novo diffuse CAD. Postprocedural QFR has some implications for prognosis and may be helpful in guiding this approach. |
Author | Chang, Yue Liu, Rong Zhu, Fasheng Yang, Weixian Wang, Juan Yuan, Jiansong Qiao, Shubin Tian, Tao Xu, Haobo Cui, Jingang Yang, Zhuoxuan Liu, Shengwen Guan, Hao Wang, Tianjie |
AuthorAffiliation | 2 Department of Cardiology Yuncheng Central Hospital Shanxi People's Republic of China 1 Department of Cardiology Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences Beijing People's Republic of China |
AuthorAffiliation_xml | – name: 1 Department of Cardiology Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences Beijing People's Republic of China – name: 2 Department of Cardiology Yuncheng Central Hospital Shanxi People's Republic of China |
Author_xml | – sequence: 1 givenname: Haobo surname: Xu fullname: Xu, Haobo organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 2 givenname: Shubin orcidid: 0000-0002-4402-6486 surname: Qiao fullname: Qiao, Shubin email: dr_qiao@163.com organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 3 givenname: Jingang surname: Cui fullname: Cui, Jingang organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 4 givenname: Jiansong orcidid: 0000-0002-7767-712X surname: Yuan fullname: Yuan, Jiansong organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 5 givenname: Weixian surname: Yang fullname: Yang, Weixian organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 6 givenname: Rong surname: Liu fullname: Liu, Rong organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 7 givenname: Tianjie surname: Wang fullname: Wang, Tianjie organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 8 givenname: Hao surname: Guan fullname: Guan, Hao organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 9 givenname: Tao surname: Tian fullname: Tian, Tao organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 10 givenname: Fasheng surname: Zhu fullname: Zhu, Fasheng organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 11 givenname: Juan surname: Wang fullname: Wang, Juan organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 12 givenname: Yue surname: Chang fullname: Chang, Yue organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences – sequence: 13 givenname: Zhuoxuan orcidid: 0000-0003-4980-8070 surname: Yang fullname: Yang, Zhuoxuan organization: Yuncheng Central Hospital – sequence: 14 givenname: Shengwen surname: Liu fullname: Liu, Shengwen organization: Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences |
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Cites_doi | 10.1161/CIRCINTERVENTIONS.109.886945 10.1016/j.ijcard.2012.01.080 10.1016/j.amjcard.2005.09.084 10.1016/j.jcin.2018.07.031 10.1016/j.jacc.2017.10.035 10.1016/j.jcin.2013.07.005 10.1016/j.carrev.2020.07.036 10.1161/CIRCINTERVENTIONS.111.965673 10.1016/j.jcin.2019.08.009 10.1016/j.jcin.2011.05.024 10.1161/CIRCINTERVENTIONS.113.000841 10.1161/CIRCULATIONAHA.113.001790 10.1016/S0140-6736(21)02248-0 10.1016/j.ijcard.2020.11.035 10.1093/eurheartj/ehy394 10.4244/EIJV11I14A309 10.31083/j.rcm2301013 10.1016/j.jcin.2019.06.003 10.1016/j.jacc.2019.12.046 10.1093/eurheartj/ehy223 10.3390/jcm10091856 |
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Copyright | 2023 The Authors. published by Wiley Periodicals LLC. 2023 The Authors. Clinical Cardiology published by Wiley Periodicals LLC. 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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Keywords | de novo diffuse coronary artery disease hybrid strategy quantitative flow ratio drug-eluting stent drug-coated balloon |
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Snippet | Background
The hybrid strategy of a combination of drug‐eluting stent (DES) and drug‐coated balloon (DCB) is promising for the treatment of de novo diffuse... The hybrid strategy of a combination of drug-eluting stent (DES) and drug-coated balloon (DCB) is promising for the treatment of de novo diffuse coronary... Abstract Background The hybrid strategy of a combination of drug‐eluting stent (DES) and drug‐coated balloon (DCB) is promising for the treatment of de novo... BackgroundThe hybrid strategy of a combination of drug-eluting stent (DES) and drug-coated balloon (DCB) is promising for the treatment of de novo diffuse... BACKGROUNDThe hybrid strategy of a combination of drug-eluting stent (DES) and drug-coated balloon (DCB) is promising for the treatment of de novo diffuse... A hybrid strategy using DES and DCB showed encouraging performance and acceptable clinical outcomes for the treatment of de novo diffuse CAD. This approach... |
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StartPage | 1511 |
SubjectTerms | Acute coronary syndromes Angioplasty Cardiovascular disease Clinical Investigations Coronary vessels de novo diffuse coronary artery disease drug‐coated balloon drug‐eluting stent Flow velocity Heart attacks hybrid strategy Medical imaging Patients quantitative flow ratio Stents Thrombosis Vein & artery diseases |
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Title | Drug‐eluting stent and drug‐coated balloon for the treatment of de novo diffuse coronary artery disease lesions: A retrospective case series study |
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