Key result
Treatment with a paclitaxel-coated balloon significantly reduced the incidence of peri-procedural myocardial infarction compared to drug-eluting stents (1.9% vs 23.1%) in patients with de novo coronary lesions.
Why the study?
Does paclitaxel-coated balloon reduce peri-procedural myocardial infarction compared to drug-eluting stents in stable patients with de novo coronary lesions?
Observational (n=104)
No
Does paclitaxel-coated balloon reduce peri-procedural myocardial infarction compared to drug-eluting stents in stable patients with de novo coronary lesions?
In stable patients undergoing elective PCI for de novo coronary lesions, treatment with a paclitaxel-coated balloon significantly reduces the risk of peri-procedural myocardial infarction compared to first-generation drug-eluting stents.
Answers are grounded in this paper and cite their sources.
PCB may lower peri-procedural MI risk versus DES in de novo lesions; leaves open need for randomized confirmation.
PURPOSE: This study compared the impact of paclitaxel-coated balloons (PCB) or drug eluting stents (DES) on peri-procedural myocardial infarction (PMI) on de novo coronary lesion in stable patients. MATERIALS AND METHODS: In this observational study, we compared the incidence of PMI amongst patients with single vessel de novo coronary lesions who underwent treatment with a PCB or DES. Propensity score-matching analysis was used to assemble a cohort of patients with similar baseline characteristics. PMI was classified as myocardial infarction occurring within 48 hours after percutaneous coronary intervention with a threshold of 5 x the 99th percentile upper reference limit of normal for creatine kinase-myocardial band (CK-MB) or troponin T (TnT). RESULTS: One hundred four patients (52 receiving PCB and 52 receiving DES) were enrolled in this study. The peak mean values of CK-MB and TnT were significantly higher in the DES group. There was a significantly higher rate of PMI in the DES group (23.1% vs. 1.9%, p=0.002). Total occlusion of the side-branch occurred in two patients treated with DES, while no patients treated with PCB. In multivariable analysis, DES was the only independent predictor of PMI compared with PCB (odds ratio 42.85, 95% confidence interval: 3.44-533.87, p=0.004). CONCLUSION: Treatment with a PCB on de novo coronary lesion might be associated with a significant reduction in the risk of PMI compared to DES.
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Her et al. (2016) conducted an observational in Stable angina pectoris with de novo coronary lesions (n=104). Paclitaxel-coated balloon (PCB) vs. Drug-eluting stent (DES) was evaluated on Peri-procedural myocardial infarction (PMI) within 48 hours (OR 42.85 (DES vs PCB), 95% CI 3.44-533.87, p=0.004). Treatment with a paclitaxel-coated balloon significantly reduced the incidence of peri-procedural myocardial infarction compared to drug-eluting stents (1.9% vs 23.1%) in patients with de novo coronary lesions.
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