Ovidio De Filippo, Wojciech Wańha, Tiziana Sanavia, Rafal Januszek, Federico Giacobbe, Gianluca Campo, Tineke H Pinxterhuis, Davide Capodanno, Brunon Tomasiewicz, Mario Iannaccone, Attilio Leone, Rafał Wolny, Francesco Bruno, Giuseppe Patti, Giuseppe Musumeci, Gaetano Liccardo, Roberto Verardi, Sergio Raposeiras Roubin, Giuseppe Tarantini, Łukasz Kuźma, Leor Perl, Andrea Gagnor, Krzysztof Reczuch, Federico Conrotto, Domenico Tuttolomondo, Eline H Ploumen, Piotr Niezgoda, Serena Caglioni, Pierluigi Omedè, Antonio Greco, Jacek Kubica, Robert J Gil, Raffaele Piccolo, Ran Kornowski, Jacek Bil, Arianna Morena, Paolo Zocca, Mauro Pennone, Mariusz Gąsior, Miłosz Jaguszewski, Clemens von Birgelen, Piero Fariselli, Gaetano M De Ferrari, Wojciech Wojakowski, Fabrizio D'Ascenzo
{"title":"用超薄支架与薄支架药物洗脱支架或药物洗脱球囊治疗支架内再狭窄：一项多中心登记。","authors":"Ovidio De Filippo, Wojciech Wańha, Tiziana Sanavia, Rafal Januszek, Federico Giacobbe, Gianluca Campo, Tineke H Pinxterhuis, Davide Capodanno, Brunon Tomasiewicz, Mario Iannaccone, Attilio Leone, Rafał Wolny, Francesco Bruno, Giuseppe Patti, Giuseppe Musumeci, Gaetano Liccardo, Roberto Verardi, Sergio Raposeiras Roubin, Giuseppe Tarantini, Łukasz Kuźma, Leor Perl, Andrea Gagnor, Krzysztof Reczuch, Federico Conrotto, Domenico Tuttolomondo, Eline H Ploumen, Piotr Niezgoda, Serena Caglioni, Pierluigi Omedè, Antonio Greco, Jacek Kubica, Robert J Gil, Raffaele Piccolo, Ran Kornowski, Jacek Bil, Arianna Morena, Paolo Zocca, Mauro Pennone, Mariusz Gąsior, Miłosz Jaguszewski, Clemens von Birgelen, Piero Fariselli, Gaetano M De Ferrari, Wojciech Wojakowski, Fabrizio D'Ascenzo","doi":"10.4244/EIJ-D-24-00491","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Limited data exist on ultrathin-strut drug-eluting stent (ultrathin DES) performance in DES in-stent restenosis (ISR).</p><p><strong>Aims: </strong>We aimed to assess the efficacy and safety of ultrathin DES compared to thin-strut DES and drug-eluting balloons (DEB) for DES-ISR.</p><p><strong>Methods: </strong>Patients from the DEB Dragon (ClinicalTrials.gov: NCT04415216) and ULTRA registries (ClinicalTrials.gov: NCT05205148) were divided into ultrathin DES, thin-strut DES, or DEB groups for DES-ISR treatment. Both propensity score matching (PSM) and inverse probability weighting (IPW) were considered to adjust the distribution of patients in each class. Cox regression was applied to the following main endpoints: device-oriented composite endpoints (DOCE; including cardiac death, target lesion revascularisation [TLR] and target vessel myocardial infarction), TLR and target vessel revascularisation (TVR).</p><p><strong>Results: </strong>A total of 269, 541, and 557 patients received an ultrathin DES, thin-strut DES, and DEB, respectively. After 3 years of follow-up, in the IPW-adjusted overall cohort, ultrathin DES were associated with a significantly reduced risk of DOCE compared to DEBs (hazard ratio [HR] 0.353, 95% confidence interval [CI]: 0.194-0.642; p<0.001), as well as thin-strut DES (HR 0.645, 95% CI: 0.457-0.911; p=0.013). Compared to DEBs, ultrathin DES also reduced the risks of both TLR (HR 0.184, 95% CI: 0.081-0.417; p<0.001) and TVR (HR 0.188, 95% CI: 0.093-0.379; p<0.001), while thin-strut DES did not (TLR: HR 0.686, 95% CI: 0.407-1.157; p=0.157; TVR: HR 0.706, 95% CI: 0.453-1.101; p=0.124). For diffuse ISR patients, ultrathin DES reduced the risk of DOCE (HR 0.364, 95% CI: 0.188-0.705; p=0.003), as did thin-strut DES (HR 0.602, 95% CI: 0.367-0.987; p=0.044), while a reduction of TLR (HR 0.220, 95% CI: 0.091-0.531; p<0.001) and TVR (HR 0.241, 95% CI: 0.113-0.513; p<0.001) was achieved only by ultrathin DES.</p><p><strong>Conclusions: </strong>Ultrathin DES were associated with reduced DOCE, TLR and TVR risks in diffuse ISR compared to DEBs.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 21","pages":"e1340-e1354"},"PeriodicalIF":7.6000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11525456/pdf/","citationCount":"0","resultStr":"{\"title\":\"Treatment of in-stent restenosis with ultrathin-strut versus thin-strut drug-eluting stents or drug-eluting balloons: a multicentre registry.\",\"authors\":\"Ovidio De Filippo, Wojciech Wańha, Tiziana Sanavia, Rafal Januszek, Federico Giacobbe, Gianluca Campo, Tineke H Pinxterhuis, Davide Capodanno, Brunon Tomasiewicz, Mario Iannaccone, Attilio Leone, Rafał Wolny, Francesco Bruno, Giuseppe Patti, Giuseppe Musumeci, Gaetano Liccardo, Roberto Verardi, Sergio Raposeiras Roubin, Giuseppe Tarantini, Łukasz Kuźma, Leor Perl, Andrea Gagnor, Krzysztof Reczuch, Federico Conrotto, Domenico Tuttolomondo, Eline H Ploumen, Piotr Niezgoda, Serena Caglioni, Pierluigi Omedè, Antonio Greco, Jacek Kubica, Robert J Gil, Raffaele Piccolo, Ran Kornowski, Jacek Bil, Arianna Morena, Paolo Zocca, Mauro Pennone, Mariusz Gąsior, Miłosz Jaguszewski, Clemens von Birgelen, Piero Fariselli, Gaetano M De Ferrari, Wojciech Wojakowski, Fabrizio D'Ascenzo\",\"doi\":\"10.4244/EIJ-D-24-00491\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Limited data exist on ultrathin-strut drug-eluting stent (ultrathin DES) performance in DES in-stent restenosis (ISR).</p><p><strong>Aims: </strong>We aimed to assess the efficacy and safety of ultrathin DES compared to thin-strut DES and drug-eluting balloons (DEB) for DES-ISR.</p><p><strong>Methods: </strong>Patients from the DEB Dragon (ClinicalTrials.gov: NCT04415216) and ULTRA registries (ClinicalTrials.gov: NCT05205148) were divided into ultrathin DES, thin-strut DES, or DEB groups for DES-ISR treatment. Both propensity score matching (PSM) and inverse probability weighting (IPW) were considered to adjust the distribution of patients in each class. Cox regression was applied to the following main endpoints: device-oriented composite endpoints (DOCE; including cardiac death, target lesion revascularisation [TLR] and target vessel myocardial infarction), TLR and target vessel revascularisation (TVR).</p><p><strong>Results: </strong>A total of 269, 541, and 557 patients received an ultrathin DES, thin-strut DES, and DEB, respectively. After 3 years of follow-up, in the IPW-adjusted overall cohort, ultrathin DES were associated with a significantly reduced risk of DOCE compared to DEBs (hazard ratio [HR] 0.353, 95% confidence interval [CI]: 0.194-0.642; p<0.001), as well as thin-strut DES (HR 0.645, 95% CI: 0.457-0.911; p=0.013). Compared to DEBs, ultrathin DES also reduced the risks of both TLR (HR 0.184, 95% CI: 0.081-0.417; p<0.001) and TVR (HR 0.188, 95% CI: 0.093-0.379; p<0.001), while thin-strut DES did not (TLR: HR 0.686, 95% CI: 0.407-1.157; p=0.157; TVR: HR 0.706, 95% CI: 0.453-1.101; p=0.124). For diffuse ISR patients, ultrathin DES reduced the risk of DOCE (HR 0.364, 95% CI: 0.188-0.705; p=0.003), as did thin-strut DES (HR 0.602, 95% CI: 0.367-0.987; p=0.044), while a reduction of TLR (HR 0.220, 95% CI: 0.091-0.531; p<0.001) and TVR (HR 0.241, 95% CI: 0.113-0.513; p<0.001) was achieved only by ultrathin DES.</p><p><strong>Conclusions: </strong>Ultrathin DES were associated with reduced DOCE, TLR and TVR risks in diffuse ISR compared to DEBs.</p>\",\"PeriodicalId\":54378,\"journal\":{\"name\":\"Eurointervention\",\"volume\":\"20 21\",\"pages\":\"e1340-e1354\"},\"PeriodicalIF\":7.6000,\"publicationDate\":\"2024-11-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11525456/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Eurointervention\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4244/EIJ-D-24-00491\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Eurointervention","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4244/EIJ-D-24-00491","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Treatment of in-stent restenosis with ultrathin-strut versus thin-strut drug-eluting stents or drug-eluting balloons: a multicentre registry.
Background: Limited data exist on ultrathin-strut drug-eluting stent (ultrathin DES) performance in DES in-stent restenosis (ISR).
Aims: We aimed to assess the efficacy and safety of ultrathin DES compared to thin-strut DES and drug-eluting balloons (DEB) for DES-ISR.
Methods: Patients from the DEB Dragon (ClinicalTrials.gov: NCT04415216) and ULTRA registries (ClinicalTrials.gov: NCT05205148) were divided into ultrathin DES, thin-strut DES, or DEB groups for DES-ISR treatment. Both propensity score matching (PSM) and inverse probability weighting (IPW) were considered to adjust the distribution of patients in each class. Cox regression was applied to the following main endpoints: device-oriented composite endpoints (DOCE; including cardiac death, target lesion revascularisation [TLR] and target vessel myocardial infarction), TLR and target vessel revascularisation (TVR).
Results: A total of 269, 541, and 557 patients received an ultrathin DES, thin-strut DES, and DEB, respectively. After 3 years of follow-up, in the IPW-adjusted overall cohort, ultrathin DES were associated with a significantly reduced risk of DOCE compared to DEBs (hazard ratio [HR] 0.353, 95% confidence interval [CI]: 0.194-0.642; p<0.001), as well as thin-strut DES (HR 0.645, 95% CI: 0.457-0.911; p=0.013). Compared to DEBs, ultrathin DES also reduced the risks of both TLR (HR 0.184, 95% CI: 0.081-0.417; p<0.001) and TVR (HR 0.188, 95% CI: 0.093-0.379; p<0.001), while thin-strut DES did not (TLR: HR 0.686, 95% CI: 0.407-1.157; p=0.157; TVR: HR 0.706, 95% CI: 0.453-1.101; p=0.124). For diffuse ISR patients, ultrathin DES reduced the risk of DOCE (HR 0.364, 95% CI: 0.188-0.705; p=0.003), as did thin-strut DES (HR 0.602, 95% CI: 0.367-0.987; p=0.044), while a reduction of TLR (HR 0.220, 95% CI: 0.091-0.531; p<0.001) and TVR (HR 0.241, 95% CI: 0.113-0.513; p<0.001) was achieved only by ultrathin DES.
Conclusions: Ultrathin DES were associated with reduced DOCE, TLR and TVR risks in diffuse ISR compared to DEBs.
期刊介绍：
EuroIntervention Journal is an international, English language, peer-reviewed journal whose aim is to create a community of high quality research and education in the field of percutaneous and surgical cardiovascular interventions.
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