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Clinical impact of optical coherence tomography findings after drug-coated balloon treatment for patients with acute coronary syndromes.
- Source :
-
International journal of cardiology [Int J Cardiol] 2023 Sep 15; Vol. 387, pp. 131149. Date of Electronic Publication: 2023 Jul 07. - Publication Year :
- 2023
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Abstract
- Background: Drug-coated balloon (DCB) became a potential treatment option for patients with acute coronary syndrome (ACS); however, factors associated with target lesion failure (TLF) remain uncertain.<br />Methods: This retrospective, multicentre, observational study included consecutive ACS patients who underwent optical coherence tomography (OCT)-guided DCB treatment. Patients were divided into two groups according to the occurrence of TLF, a composite of cardiac death, target vessel-related myocardial infarction, and ischemia-driven target lesion revascularisation.<br />Results: We enrolled 127 patients in this study. During the median follow-up period of 562 (IQR: 342-1164) days, 24 patients (18.9%) experienced TLF, and 103 patients (81.1%) did not. The cumulative 3-year incidence of TLF was 22.0%. The cumulative 3-year incidence of TLF was the lowest in patients with plaque erosion (PE) (7.5%), followed by those with rupture (PR) (26.1%) and calcified nodule (CN) (43.5%). Multivariable Cox regression analysis revealed that plaque morphology was independently associated with TLF on pre-PCI (percutaneous coronary intervention) OCT, and residual thrombus burden (TB) was positively associated with TLF on post-PCI OCT. Further stratification by post-PCI TB revealed a comparable incidence of TLF in patients with PR (4.2%) to that of PE if the culprit lesion had a smaller post-PCI TB than the cut-off value (8.4%). TLF incidence was high in patients with CN, regardless of TB size on post-PCI OCT.<br />Conclusions: Plaque morphology was strongly associated with TLF for ACS patients after DCB treatment. Residual TB post-PCI might be a key determinant for TLF, especially in patients with PR.<br />Competing Interests: Declaration of Competing Interest None declared.<br /> (Copyright © 2023 Elsevier B.V. All rights reserved.)
- Subjects :
- Humans
Tomography, Optical Coherence methods
Retrospective Studies
Coronary Angiography methods
Treatment Outcome
Coronary Vessels pathology
Acute Coronary Syndrome diagnostic imaging
Acute Coronary Syndrome epidemiology
Acute Coronary Syndrome surgery
Percutaneous Coronary Intervention adverse effects
Percutaneous Coronary Intervention methods
Plaque, Atherosclerotic diagnostic imaging
Plaque, Atherosclerotic surgery
Plaque, Atherosclerotic etiology
Coronary Artery Disease therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 387
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 37423566
- Full Text :
- https://doi.org/10.1016/j.ijcard.2023.131149