Yonsei Med J.  2017 Jan;58(1):99-104. 10.3349/ymj.2017.58.1.99.

A Comparison of Peri-Procedural Myocardial Infarction between Paclitaxel-Coated Balloon and Drug-Eluting Stent on De Novo Coronary Lesions

• Her AY
• Cho KI
• Singh GB
• Garg S
• Kim YH
• Koo BK
• Shin ES

• KMID: 2374194
• DOI: http://doi.org/10.3349/ymj.2017.58.1.99

Abstract

PURPOSE
This study compared the impact of paclitaxel-coated balloons (PCB) or drug eluting stents (DES) on peri-procedural myocardial infarction (PMI) on de novo coronary lesion in stable patients.
MATERIALS AND METHODS
In this observational study, we compared the incidence of PMI amongst patients with single vessel de novo coronary lesions who underwent treatment with a PCB or DES. Propensity score-matching analysis was used to assemble a cohort of patients with similar baseline characteristics. PMI was classified as myocardial infarction occurring within 48 hours after percutaneous coronary intervention with a threshold of 5 x the 99th percentile upper reference limit of normal for creatine kinase-myocardial band (CK-MB) or troponin T (TnT).
RESULTS
One hundred four patients (52 receiving PCB and 52 receiving DES) were enrolled in this study. The peak mean values of CK-MB and TnT were significantly higher in the DES group. There was a significantly higher rate of PMI in the DES group (23.1% vs. 1.9%, p=0.002). Total occlusion of the side-branch occurred in two patients treated with DES, while no patients treated with PCB. In multivariable analysis, DES was the only independent predictor of PMI compared with PCB (odds ratio 42.85, 95% confidence interval: 3.44-533.87, p=0.004).
CONCLUSION
Treatment with a PCB on de novo coronary lesion might be associated with a significant reduction in the risk of PMI compared to DES.

Keyword

Paclitaxel-coated balloon; drug eluting stent; peri-procedural; myocardial infarction; de novo coronary artery

MeSH Terms

Aged
Creatine Kinase, MB Form/analysis
*Drug-Eluting Stents
Female
Humans
Incidence
Kaplan-Meier Estimate
Middle Aged
Myocardial Infarction/enzymology/epidemiology/etiology/*prevention & control
Odds Ratio
Paclitaxel/*therapeutic use
Percutaneous Coronary Intervention/*adverse effects
Propensity Score
Time Factors
Treatment Outcome
Creatine Kinase, MB Form
Paclitaxel

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