Long-Term Outcomes of Drug-Coated Balloon Angioplasty in The Treatment of Small Vessel Coronary Artery Disease

Mujtaba Ahmed, Khawar Naeem Satti, Asim Javed, Fatima Noor, Muhammad Mohsin, Aimen Javed
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Abstract

Long-Term Outcomes of Drug-Coated Balloon Angioplasty in The Treatment of Small Vessel Coronary Artery Disease Objectives: To determine the outcomes in patients with small-vessel disease (SVD) who underwent percutaneous coronary intervention (PCI) with a drug-coated balloon (DCB) and correlate these adverse outcomes with various risk factors. Methodology: The prospective cohort study was conducted at the Rawalpindi Institute of Cardiology (RIC) from January 2020 to December 2022. After being approved by the Hospital Ethics Committee, fifty-four patients who presented with SVD were enrolled using non-probability consecutive sampling. Written informed consent was obtained from the patients. They were treated with DCB and observed clinically on follow-ups at 15, 30, 60, and 90 days, & later after every 6 months for up to 2 years. Only those patients who presented with symptoms underwent repeat angiography. The outcomes assessed were cardiovascular mortality, myocardial infarction (MI), and target lesion revascularization (TLR). Results: Cardiovascular mortality occurred in 2(3.7%), MI in 3(5.6%) and TLR in 2(3.7%) patients. There was a significant association between cardiovascular mortality, MI, and TLR with diabetes mellitus and BMI. Age was only significantly related to cardiovascular mortality. Conclusion: A drug-coated balloon is an effective and feasible treatment modality for small vessel disease. The incidence of outcomes of cardiovascular mortality, MI, and TLR after DCB is low, making it a safe modality. Advanced age, obesity, and diabetes mellitus alone or with hypertension are the predicting factors of adverse outcomes after DCB in patients with SVD. Keywords: Drug-coated balloon, DCB, Small vessel coronary artery disease, SVD
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药物包被球囊血管成形术治疗小血管冠状动脉疾病的远期疗效
药物包被球囊成形术治疗小血管冠状动脉疾病的长期结果目的:确定小血管疾病(SVD)患者接受经皮冠状动脉介入治疗(PCI)的药物包被球囊(DCB)的结果,并将这些不良结果与各种危险因素联系起来。方法:前瞻性队列研究于2020年1月至2022年12月在拉瓦尔品第心脏病研究所(RIC)进行。经医院伦理委员会批准,采用非概率连续抽样方法纳入54例SVD患者。获得患者的书面知情同意。他们接受DCB治疗,并在15、30、60和90天进行临床随访,之后每6个月随访一次,随访时间长达2年。只有那些出现症状的患者才进行了重复血管造影。评估的结果是心血管死亡率、心肌梗死(MI)和靶病变血运重建术(TLR)。结果:心血管死亡2例(3.7%),心肌梗死3例(5.6%),TLR 2例(3.7%)。心血管死亡率、心肌梗死和TLR与糖尿病和BMI之间存在显著相关性。年龄仅与心血管疾病死亡率显著相关。结论:药物包被球囊是治疗小血管疾病有效可行的方法。DCB后心血管死亡率、心肌梗死和TLR的发生率较低,使其成为一种安全的方式。高龄、肥胖、糖尿病单独或合并高血压是SVD患者行DCB后不良结局的预测因素。关键词:药物包被球囊,DCB,小血管冠状动脉疾病,SVD
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