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Effect of Adjunct Balloon Dilation after Long Everolimus-eluting Stent Deployment on Major Adverse Cardiac Events

BACKGROUND AND OBJECTIVES: The effectiveness of adjunct balloon dilation after drug-eluting stent (DES) deployment has not been sufficiently evaluated. We evaluated whether adjunct balloon dilation was associated with a reduction in major adverse cardiac events (MACEs) after long everolimus-eluting...

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Autores principales: Hong, Sung-Jin, Ahn, Chul-Min, Shin, Dong-Ho, Kim, Jung-Sun, Kim, Byeong-Keuk, Ko, Young-Guk, Choi, Donghoon, Her, Ae-Young, Kim, Yong Hoon, Jang, Yangsoo, Hong, Myeong-Ki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5614946/
https://www.ncbi.nlm.nih.gov/pubmed/28955388
http://dx.doi.org/10.4070/kcj.2017.0016
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author Hong, Sung-Jin
Ahn, Chul-Min
Shin, Dong-Ho
Kim, Jung-Sun
Kim, Byeong-Keuk
Ko, Young-Guk
Choi, Donghoon
Her, Ae-Young
Kim, Yong Hoon
Jang, Yangsoo
Hong, Myeong-Ki
author_facet Hong, Sung-Jin
Ahn, Chul-Min
Shin, Dong-Ho
Kim, Jung-Sun
Kim, Byeong-Keuk
Ko, Young-Guk
Choi, Donghoon
Her, Ae-Young
Kim, Yong Hoon
Jang, Yangsoo
Hong, Myeong-Ki
author_sort Hong, Sung-Jin
collection PubMed
description BACKGROUND AND OBJECTIVES: The effectiveness of adjunct balloon dilation after drug-eluting stent (DES) deployment has not been sufficiently evaluated. We evaluated whether adjunct balloon dilation was associated with a reduction in major adverse cardiac events (MACEs) after long everolimus-eluting stents (EESs) implantation. SUBJECTS AND METHODS: Drawing from 2 randomized trials, a total of 1,672 patients treated with long EES were analyzed. Of 1,672 patients, 1,061 patients (64%) received post-stent adjunct balloon dilation. MACE, defined as a composite of cardiac death, myocardial infarction, and target-lesion revascularization (TLR), was compared between patients who received post-stent adjunct balloon dilation and patients who did not in 595 propensity score-matched pairs. RESULTS: For the matched population, MACE occurred in 29 patients (4.9%) who received adjunct balloon dilation and in 29 patients (4.9%) who did not (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.60–1.69; p=0.972). However, significant interactions were observed among the subgroups for clinical presentation and vessel size. Adjunct balloon dilation was more favored within the subset of patients with stable angina vs. the subset of patients with acute coronary syndrome (p for interaction=0.037), and within the subset of lesions with small vessel diameter (reference vessel diameter [RVD] <3 mm) vs. the subset of lesions with larger vessel diameter (RVD ≥3 mm; p for interaction=0.027). CONCLUSION: Adjunct balloon dilation was not associated with MACE reduction at 1 year among patients requiring long EES implantation. However, post-stent adjunct balloon dilation may be necessary for patients requiring long EES implantation who present with stable angina or for lesions with small vessel diameters.
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spelling pubmed-56149462017-09-27 Effect of Adjunct Balloon Dilation after Long Everolimus-eluting Stent Deployment on Major Adverse Cardiac Events Hong, Sung-Jin Ahn, Chul-Min Shin, Dong-Ho Kim, Jung-Sun Kim, Byeong-Keuk Ko, Young-Guk Choi, Donghoon Her, Ae-Young Kim, Yong Hoon Jang, Yangsoo Hong, Myeong-Ki Korean Circ J Original Article BACKGROUND AND OBJECTIVES: The effectiveness of adjunct balloon dilation after drug-eluting stent (DES) deployment has not been sufficiently evaluated. We evaluated whether adjunct balloon dilation was associated with a reduction in major adverse cardiac events (MACEs) after long everolimus-eluting stents (EESs) implantation. SUBJECTS AND METHODS: Drawing from 2 randomized trials, a total of 1,672 patients treated with long EES were analyzed. Of 1,672 patients, 1,061 patients (64%) received post-stent adjunct balloon dilation. MACE, defined as a composite of cardiac death, myocardial infarction, and target-lesion revascularization (TLR), was compared between patients who received post-stent adjunct balloon dilation and patients who did not in 595 propensity score-matched pairs. RESULTS: For the matched population, MACE occurred in 29 patients (4.9%) who received adjunct balloon dilation and in 29 patients (4.9%) who did not (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.60–1.69; p=0.972). However, significant interactions were observed among the subgroups for clinical presentation and vessel size. Adjunct balloon dilation was more favored within the subset of patients with stable angina vs. the subset of patients with acute coronary syndrome (p for interaction=0.037), and within the subset of lesions with small vessel diameter (reference vessel diameter [RVD] <3 mm) vs. the subset of lesions with larger vessel diameter (RVD ≥3 mm; p for interaction=0.027). CONCLUSION: Adjunct balloon dilation was not associated with MACE reduction at 1 year among patients requiring long EES implantation. However, post-stent adjunct balloon dilation may be necessary for patients requiring long EES implantation who present with stable angina or for lesions with small vessel diameters. The Korean Society of Cardiology 2017-09 2017-09-18 /pmc/articles/PMC5614946/ /pubmed/28955388 http://dx.doi.org/10.4070/kcj.2017.0016 Text en Copyright © 2017. The Korean Society of Cardiology https://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hong, Sung-Jin
Ahn, Chul-Min
Shin, Dong-Ho
Kim, Jung-Sun
Kim, Byeong-Keuk
Ko, Young-Guk
Choi, Donghoon
Her, Ae-Young
Kim, Yong Hoon
Jang, Yangsoo
Hong, Myeong-Ki
Effect of Adjunct Balloon Dilation after Long Everolimus-eluting Stent Deployment on Major Adverse Cardiac Events
title Effect of Adjunct Balloon Dilation after Long Everolimus-eluting Stent Deployment on Major Adverse Cardiac Events
title_full Effect of Adjunct Balloon Dilation after Long Everolimus-eluting Stent Deployment on Major Adverse Cardiac Events
title_fullStr Effect of Adjunct Balloon Dilation after Long Everolimus-eluting Stent Deployment on Major Adverse Cardiac Events
title_full_unstemmed Effect of Adjunct Balloon Dilation after Long Everolimus-eluting Stent Deployment on Major Adverse Cardiac Events
title_short Effect of Adjunct Balloon Dilation after Long Everolimus-eluting Stent Deployment on Major Adverse Cardiac Events
title_sort effect of adjunct balloon dilation after long everolimus-eluting stent deployment on major adverse cardiac events
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5614946/
https://www.ncbi.nlm.nih.gov/pubmed/28955388
http://dx.doi.org/10.4070/kcj.2017.0016
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