Obieda Altobaishat, Mohamed Abouzid, Mohammad Tanashat, Ahmed Mazen Amin, Mustafa Turkmani, Mohamed Abuelazm
{"title":"在严重钙化的冠状动脉病变中，支架置入前采用球囊切割旋转动脉粥样硬化切除术：一项荟萃分析。","authors":"Obieda Altobaishat, Mohamed Abouzid, Mohammad Tanashat, Ahmed Mazen Amin, Mustafa Turkmani, Mohamed Abuelazm","doi":"10.1080/14796678.2024.2440220","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Rotational atherectomy (RA) has been proven to treat coronary artery calcification (CAC) during percutaneous coronary intervention (PCI).</p><p><strong>Purpose: </strong>This study evaluates the safety and efficacy of RA followed by cutting balloon angioplasty (ROTACUT) before stent placement in CAC.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials and observational studies was conducted. PubMed, Web of Science, Scopus, and Cochrane were searched through January 2024. We used Stata version 17 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI).</p><p><strong>Results: </strong>Eight studies with 846 patients were included. There was no significant difference between ROTACUT and RA + bare balloons in major adverse cardiovascular events (MACE) (RR:0.60; 95%CI [0.31,1.16], <i>p</i> = 0.13), cardiac death (RR:1.32; 95%CI [0.42,4.14], <i>p</i> = 0.64), target vessel revascularization (TVR) (RR:1.89; 95%CI [0.40,8.84], <i>p</i> = 0.42), target lesion revascularization (TLR) (RR:0.83; 95%CI [0.39,1.79], <i>p</i> = 0.64), procedural duration (MD:0.78; 95%CI [-4.68,6.24], <i>p</i> = 0.78), stent thrombosis (RR:0.81; 95%CI [0.22,2.95], <i>p</i> = 0.75), and any procedure-related complications (RR:0.86; 95%CI [0.42,1.75], <i>p</i> = 0.68).</p><p><strong>Conclusion: </strong>ROTACUT and RA + bare balloons demonstrated similar efficacy and safety profiles regarding MACE, cardiac death, TVR, TLR, procedural duration, stent thrombosis, and all safety outcomes.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"859-870"},"PeriodicalIF":1.6000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731055/pdf/","citationCount":"0","resultStr":"{\"title\":\"Rotational atherectomy with cutting balloon before stenting in severely calcified coronary lesions: a meta-analysis.\",\"authors\":\"Obieda Altobaishat, Mohamed Abouzid, Mohammad Tanashat, Ahmed Mazen Amin, Mustafa Turkmani, Mohamed Abuelazm\",\"doi\":\"10.1080/14796678.2024.2440220\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Rotational atherectomy (RA) has been proven to treat coronary artery calcification (CAC) during percutaneous coronary intervention (PCI).</p><p><strong>Purpose: </strong>This study evaluates the safety and efficacy of RA followed by cutting balloon angioplasty (ROTACUT) before stent placement in CAC.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials and observational studies was conducted. PubMed, Web of Science, Scopus, and Cochrane were searched through January 2024. We used Stata version 17 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI).</p><p><strong>Results: </strong>Eight studies with 846 patients were included. There was no significant difference between ROTACUT and RA + bare balloons in major adverse cardiovascular events (MACE) (RR:0.60; 95%CI [0.31,1.16], <i>p</i> = 0.13), cardiac death (RR:1.32; 95%CI [0.42,4.14], <i>p</i> = 0.64), target vessel revascularization (TVR) (RR:1.89; 95%CI [0.40,8.84], <i>p</i> = 0.42), target lesion revascularization (TLR) (RR:0.83; 95%CI [0.39,1.79], <i>p</i> = 0.64), procedural duration (MD:0.78; 95%CI [-4.68,6.24], <i>p</i> = 0.78), stent thrombosis (RR:0.81; 95%CI [0.22,2.95], <i>p</i> = 0.75), and any procedure-related complications (RR:0.86; 95%CI [0.42,1.75], <i>p</i> = 0.68).</p><p><strong>Conclusion: </strong>ROTACUT and RA + bare balloons demonstrated similar efficacy and safety profiles regarding MACE, cardiac death, TVR, TLR, procedural duration, stent thrombosis, and all safety outcomes.</p>\",\"PeriodicalId\":12589,\"journal\":{\"name\":\"Future cardiology\",\"volume\":\" \",\"pages\":\"859-870\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731055/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Future cardiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/14796678.2024.2440220\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Future cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/14796678.2024.2440220","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/12 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：旋转动脉粥样硬化切除术（RA）已被证明可以治疗经皮冠状动脉介入治疗（PCI）期间的冠状动脉钙化（CAC）。目的：本研究评价类风湿性关节炎患者在CAC支架置入术前行切开球囊血管成形术（ROTACUT）的安全性和有效性。方法：对随机对照试验和观察性研究进行系统回顾和荟萃分析。PubMed、Web of Science、Scopus和Cochrane的检索截止到2024年1月。我们使用Stata version 17使用风险比（RR）合并二分类数据，使用均值差（MD）合并连续数据，置信区间为95%。结果：纳入8项研究，共846例患者。ROTACUT与RA +裸球囊在主要不良心血管事件（MACE）方面无显著差异(RR:0.60；95%可信区间[0.31,1.16],p = 0.13),心脏死亡(RR: 1.32;95%CI [0.42,4.14], p = 0.64)，靶血管重建术（TVR） (RR:1.89；95%CI [0.40,8.84], p = 0.42)，靶病变血运重建术（TLR） (RR:0.83；95%CI [0.39,1.79], p = 0.64)、手术时间(MD:0.78；95%可信区间[-4.68,6.24],p = 0.78),支架血栓形成(RR: 0.81;95%CI [0.22,2.95], p = 0.75)，以及任何手术相关并发症(RR:0.86；95%CI [0.42,1.75], p = 0.68)。结论：ROTACUT和RA +裸气球在MACE、心源性死亡、TVR、TLR、手术时间、支架血栓形成和所有安全性指标方面具有相似的疗效和安全性。
Rotational atherectomy with cutting balloon before stenting in severely calcified coronary lesions: a meta-analysis.
Background: Rotational atherectomy (RA) has been proven to treat coronary artery calcification (CAC) during percutaneous coronary intervention (PCI).
Purpose: This study evaluates the safety and efficacy of RA followed by cutting balloon angioplasty (ROTACUT) before stent placement in CAC.
Methods: A systematic review and meta-analysis of randomized controlled trials and observational studies was conducted. PubMed, Web of Science, Scopus, and Cochrane were searched through January 2024. We used Stata version 17 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI).
Results: Eight studies with 846 patients were included. There was no significant difference between ROTACUT and RA + bare balloons in major adverse cardiovascular events (MACE) (RR:0.60; 95%CI [0.31,1.16], p = 0.13), cardiac death (RR:1.32; 95%CI [0.42,4.14], p = 0.64), target vessel revascularization (TVR) (RR:1.89; 95%CI [0.40,8.84], p = 0.42), target lesion revascularization (TLR) (RR:0.83; 95%CI [0.39,1.79], p = 0.64), procedural duration (MD:0.78; 95%CI [-4.68,6.24], p = 0.78), stent thrombosis (RR:0.81; 95%CI [0.22,2.95], p = 0.75), and any procedure-related complications (RR:0.86; 95%CI [0.42,1.75], p = 0.68).
Conclusion: ROTACUT and RA + bare balloons demonstrated similar efficacy and safety profiles regarding MACE, cardiac death, TVR, TLR, procedural duration, stent thrombosis, and all safety outcomes.
期刊介绍：
Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.
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