Impact of paclitaxel-coated balloon versus newer-generation drug-eluting stent on periprocedural myocardial infarction in stable angina patients.

Ae-Young Her, Yong Hoon Kim, Scot Garg, Eun-Seok Shin

Journal: Coronary artery disease 2019;29(5):403-408

PMID: 29620557

Abstract

OBJECTIVES

Periprocedural myocardial infarction (PMI) is reported to be associated with adverse long-term clinical outcomes. This study compared the rates of PMI following treatment of de novo coronary lesions using either a paclitaxel-coated balloon (PCB) or a newer-generation drug-eluting stent (DES).

PATIENTS AND METHODS

We compared the incidence of PMI in propensity-matched patients with stable angina pectoris and single-vessel de novo coronary lesions who underwent treatment with a PCB or newer-generation DES. Propensity score matching was performed to adjust for differences in baseline clinical and angiographic characteristics.

RESULTS

After propensity matching, the study cohort included 108 patients (PCB: n=54 and DES: n=54). The peak mean values of creatine kinase-myocardial band (13.3±26.3 vs. 2.2±2.8 ng/ml, P=0.003) and high-sensitive troponin T (0.62±1.38 vs. 0.09±0.19 ng/ml, P=0.007) were significantly higher in the DES group compared with the PCB group. The incidence of PMI was significantly higher in the DES group [DES: 11 (20.4%) vs. PCB: one (1.9%); P=0.002]. Total occlusion of the side-branch occurred in two patients treated with DES, but no patients treated with PCB. Treatment with a newer-generation DES was found to be an independent predictor of PMI on multivariable analyses.

CONCLUSION

In patients with stable angina using a PCB, compared with deployment of a newer-generation DES, is associated with a significant reduction in the risk of PMI.

Address: Department of Internal Medicine, Division of Cardiology, Kangwon National University School of Medicine, Chuncheon.; East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, UK.; Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.; Division of Cardiology, Dietrich Bonhoeffer Hospital, Academic Teaching Hospital of University of Greifswald, Germany.

DOI: 10.1097/MCA.0000000000000620

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MeSH Terms: Aged, Angina, Stable, Angioplasty, Balloon, Coronary, Biomarkers, Cardiac Catheters, Cardiovascular Agents, Coated Materials, Biocompatible, Coronary Angiography, Creatine Kinase, MB Form, Databases, Factual, Drug-Eluting Stents, Female, Humans, Incidence, Male, Middle Aged, Myocardial Infarction, Paclitaxel, Propensity Score, Prosthesis Design, Republic of Korea, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Troponin T