The
incidence of acute myocardial infarction (AMI) is increasing year by year,
which seriously endangers human health around the world. The preferred
treatment strategy for AMI patients is the use of drug-eluting stents(DES), as there is ample
evidence to suggest that stent implantation can reduce major adverse
cardiovascular events (MACEs).With
the application of drug-coated balloons (DCBs) and the enhancement of the
concept of interventional without implantation, the question is whether DCBs
can be safely and effectively used in patients with AMI? The purpose of this
study was to investigate the safety and effectiveness of DCBs in the treatment
of AMI. A retrospective review of clinical data was conducted on 55 AMI
patients who underwent primary percutaneous coronary intervention (PCI) from
January 2020 to December 2021. Of these patients, 25 were treated with DCBs and
30 were treated with DESs. Optical coherence tomography (OCT) was used to
measure the minimum lumen diameter, lumen stenosis, and coronary artery
dissection before and after surgery, and angina pectoris attacks and various
MACEs were recorded at 1, 6, and 12 months after surgery. The results showed
that there were no significant differences in clinical baseline data between
the two groups. However, the minimum lumen diameter of the DCB group
immediately after the operation was smaller than that of the DES group, and the
stenosis degree of the lumen in the DCB group was higher than that in the DES
group. The incidence of coronary artery dissection in the DCB group was
significantly higher than that in the DES group, but the majority of them were
type B. At 1, 6, and 12 months after treatment, there was no significant
difference in the occurrence of MACEs between the two groups. In conclusion,
DCBs is a safe and effective treatment for AMI. However, the incidence of
coronary artery dissection in DCB patients is higher than that in DES patients,
but the majority of them are type B.
References
[1]
Byrne, R.A., Joner, M. and Kastrati, A. (2015) Stent Thrombosis and Restenosis: What Have We Learned and Where Are We Going? The Andreas Grüntzig Lecture ESC 2014. European Heart Journal, 36, 3320-3331.
https://doi.org/10.1093/eurheartj/ehv511
[2]
Madhavan, M.V., Kirtane, A.J., Redfors, B., Généreux, P., Ben-Yehuda, O., Palmerini, T., et al. (2020) Stent-Related Adverse Events >1 Year after Percutaneous Coronary Intervention. Journal of the American College of Cardiology, 75, 590-604.
https://doi.org/10.1016/j.jacc.2019.11.058
[3]
Authors/Task Force members, Windecker, S., Kolh, P., Alfonso, F., Collet, J.P., Cremer, J., et al. (2014) 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). European Heart Journal, 35, 2541-2619. https://doi.org/10.1093/eurheartj/ehu278
[4]
Stone, G.W., Witzenbichler, B., Guagliumi, G., Peruga, J.Z., Brodie, B.R. and Dudek, D. (2011) Heparin Plus a Glycoprotein IIb/IIIa Inhibitor versus Bivalirudin Monotherapy and Paclitaxel-Eluting Stents versus Bare-Metal Stents in Acute Myocardial Infarction (HORIZONS-AMI): Final 3-Year Results from a Multicentre, Randomised Controlled Trial. Lancet, 377, 2193-2204.
https://doi.org/10.1016/S0140-6736(11)60764-2
[5]
Hao, X., Huang, D., Wang, Z., Zhang, J., Liu, H. and Lu, Y. (2021) Study on the Safety and Effectiveness of Drug-Coated Balloons in Patients with Acute Myocardial Infarction. Journal of Cardiothoracic Surgery, 16, Article No. 178.
https://doi.org/10.1186/s13019-021-01525-8
[6]
Ullrich, H., Olschewski, M., Münzel, T. and Gori, T. (2021) Coronary In-Stent Restenosis: Predictors and Treatment. Deutsches Arzteblatt International, 118, 637- 644. https://doi.org/10.3238/arztebl.m2021.0254
[7]
Gulizia, M.M., Colivicchi, F., Abrignani, M.G., Ambrosetti, M., Aspromonte, N., Barile, G., et al. (2018) Consensus Document ANMCO/ANCE/ARCA/GICR- IACPR/GISE/SICOA: Long-term Antiplatelet Therapy in Patients with Coronary Artery Disease. European Heart Journal Supplements, 20, F1-F74.
https://doi.org/10.1093/eurheartj/suy019
[8]
Li, M., Guo, C., Lv, Y.H., Zhang, M.B. and Wang, Z.L. (2019) Drug-Coated Balloon versus Drug-Eluting Stent in De Novo Small Coronary Vessel Disease: A Systematic Review and Meta-Analysis. Medicine, 98, e15622.
https://doi.org/10.1097/MD.0000000000015622
[9]
Gobic, D., Tomulic, V., Lulic, D., Zidan, D., Brusich, S., Jakljevic, T., et al. (2017) Drug-Coated Balloon versus Drug-Eluting Stent in Primary Percutaneous Coronary Intervention: A Feasibility Study. Am J Med Sci, 354, 553-560.
https://doi.org/10.1016/j.amjms.2017.07.005
[10]
Scheller, B., Ohlow, M.A., Ewen, S., Kische, S., Rudolph, T.K., Clever, Y.P., et al. (2020) Bare Metal or Drug-Eluting Stent versus Drug-Coated Balloon in Non-ST-Elevation Myocardial Infarction: The Randomised PEPCAD NSTEMI Trial. EuroIntervention, 15, 1527-1533. https://doi.org/10.4244/EIJ-D-19-00723
[11]
Vos, N.S., van der Schaaf, R.J., Amoroso, G., Herrman, J.P., Patterson, M.S., Slagboom, T., et al. (2016) REVascularization with PaclitaxEL-Coated Balloon Angioplasty versus Drug-Eluting Stenting in Acute Myocardial InfarcTION—A Randomized Controlled Trial: Rationale and Design of the REVELATION Trial. Catheterization and Cardiovascular Interventions, 87, 1213-1221.
https://doi.org/10.1002/ccd.26241
