Key result
Balloon post-dilation during coronary angioplasty for acute coronary syndrome was not associated with a reduction in major adverse cardiac events over one year, but improved post-interventional TIMI flow.
Why the study?
Although post-dilatation enhances angioplasty outcomes through stent expansion, reports of increased mortality and morbidity in AMI patients have caused controversies regarding its efficiency.
Does balloon post-dilatation improve TIMI flow or reduce adverse clinical outcomes in patients undergoing angioplasty for acute coronary syndrome?
Cross-Sectional (n=500)
Yes
Does balloon post-dilatation improve TIMI flow or reduce adverse clinical outcomes in patients undergoing angioplasty for acute coronary syndrome?
Absolute Event Rate: 2.79% vs 2.65%
p-value: p=0.049
Balloon post-dilation during angioplasty for acute coronary syndrome may improve TIMI flow but does not significantly reduce the incidence of major adverse cardiac events at 12 months.
Introduction: Post-dilatation is associated with a simultaneous expansion of the stents that enhances the angioplasty outcomes. However, increased risk of mortality and morbidity has been reported in patients with acute myocardial infarction (AMI) which has provoked considerable controversies concerning its efficiency. Materials and Methods: During a two-year period, all patients underwent angioplasty with or without post-dilatation procedure, due to clinical features of the acute coronary syndrome (ACS), including unstable angina, non-ST-elevated myocardial infarction, and AMI, were included. The patients underwent 12 months of follow-ups after the angioplasty with or without post-dilatation. The primary endpoint was the TIMI flow of coronary artery after intervention. However, mortality, readmission due to ACS, need for revascularization, and incidence of AMI during 12 months, were secondary endpoints. Results: No significant difference was observed in terms of demographic data between the groups with and without post-dilatation. Comparing mortality rate, the prevalence of AMI, intervention for revascularization and incidence of major adverse cardiac events (MACE) during the follow-up period showed no significant difference between the study groups. Conclusion: Based on the findings of the present study, balloon post-dilation was not associated with a reduction in MACE incidence. However, post-dilation may improve the TIMI flow in these patients.
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Separham et al. (2020) conducted a cross-sectional in Acute Coronary Syndrome (ACS) (n=500). Balloon post-dilatation vs. No post-dilatation was evaluated on TIMI flow score after intervention (p=0.049). Balloon post-dilation during coronary angioplasty for acute coronary syndrome was not associated with a reduction in major adverse cardiac events over one year, but improved post-interventional TIMI flow.
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