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Drug-Coated Balloon vs. Drug-Eluting Stents for De Novo Unprotected Left Main Stem Disease: The SPARTAN-LMS Study

The objective of this study is to compare the outcomes of patients treated with drug-coated balloons (DCBs) or second-generation drug-eluting stents (DESs) for de novo unprotected left main stem (LMS) disease. Previous studies comparing the treatment of LMS disease suggest that the mortality for DES...

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Autores principales: Gunawardena, Tharusha D., Corballis, Natasha, Merinopoulos, Ioannis, Wickramarachchi, Upul, Reinhold, Johannes, Maart, Clint, Sreekumar, Sulfi, Sawh, Chris, Wistow, Trevor, Sarev, Toomas, Ryding, Alisdair, Gilbert, Tim J., Clark, Allan, Vassiliou, Vassilios S., Eccleshall, Simon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9963161/
https://www.ncbi.nlm.nih.gov/pubmed/36826580
http://dx.doi.org/10.3390/jcdd10020084
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author Gunawardena, Tharusha D.
Corballis, Natasha
Merinopoulos, Ioannis
Wickramarachchi, Upul
Reinhold, Johannes
Maart, Clint
Sreekumar, Sulfi
Sawh, Chris
Wistow, Trevor
Sarev, Toomas
Ryding, Alisdair
Gilbert, Tim J.
Clark, Allan
Vassiliou, Vassilios S.
Eccleshall, Simon
author_facet Gunawardena, Tharusha D.
Corballis, Natasha
Merinopoulos, Ioannis
Wickramarachchi, Upul
Reinhold, Johannes
Maart, Clint
Sreekumar, Sulfi
Sawh, Chris
Wistow, Trevor
Sarev, Toomas
Ryding, Alisdair
Gilbert, Tim J.
Clark, Allan
Vassiliou, Vassilios S.
Eccleshall, Simon
author_sort Gunawardena, Tharusha D.
collection PubMed
description The objective of this study is to compare the outcomes of patients treated with drug-coated balloons (DCBs) or second-generation drug-eluting stents (DESs) for de novo unprotected left main stem (LMS) disease. Previous studies comparing the treatment of LMS disease suggest that the mortality for DES PCI is not worse than CABG. There are limited data from studies investigating the treatment of de novo LMS disease with DCB angioplasty. We compared the all-cause and cardiac mortality of patients treated with paclitaxel DCB to those with second-generation DES for de novo LMS disease from July 2014 to November 2019. Data were analysed using Kaplan–Meier analyses and propensity-matched analyses. A total of 148 patients were treated with either a DCB or DES strategy. There was no significant difference in all-cause mortality in the DCB group (19.5%) compared to the DES group (15.9%) (HR 1.42 [0.61–3.32], p = 0.42). Regarding cardiac mortality, 2 (4.9%) were recorded for the DCB group and 7 (6.5%) for the DES group (HR 1.21 [0.31–4.67], p = 0.786); for target vessel myocardial infarction, there were 0 (0%) for the DCB group and 7 (6.5%) for the DES group; and for target lesion revascularisation, there were 3 (7.3%) in the DCB group and 9 (8.3%) in the DES group (HR: 0.89 [0.24–3.30]). p = 0.86. These remained not significant after propensity score matching. We found no difference in the mortality outcomes with DCB angioplasty compared to second-generation DES, with a median follow-up of 33 months. DCB can therefore be regarded as a safe option in the treatment of LMS disease in suitable patients.
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spelling pubmed-99631612023-02-26 Drug-Coated Balloon vs. Drug-Eluting Stents for De Novo Unprotected Left Main Stem Disease: The SPARTAN-LMS Study Gunawardena, Tharusha D. Corballis, Natasha Merinopoulos, Ioannis Wickramarachchi, Upul Reinhold, Johannes Maart, Clint Sreekumar, Sulfi Sawh, Chris Wistow, Trevor Sarev, Toomas Ryding, Alisdair Gilbert, Tim J. Clark, Allan Vassiliou, Vassilios S. Eccleshall, Simon J Cardiovasc Dev Dis Article The objective of this study is to compare the outcomes of patients treated with drug-coated balloons (DCBs) or second-generation drug-eluting stents (DESs) for de novo unprotected left main stem (LMS) disease. Previous studies comparing the treatment of LMS disease suggest that the mortality for DES PCI is not worse than CABG. There are limited data from studies investigating the treatment of de novo LMS disease with DCB angioplasty. We compared the all-cause and cardiac mortality of patients treated with paclitaxel DCB to those with second-generation DES for de novo LMS disease from July 2014 to November 2019. Data were analysed using Kaplan–Meier analyses and propensity-matched analyses. A total of 148 patients were treated with either a DCB or DES strategy. There was no significant difference in all-cause mortality in the DCB group (19.5%) compared to the DES group (15.9%) (HR 1.42 [0.61–3.32], p = 0.42). Regarding cardiac mortality, 2 (4.9%) were recorded for the DCB group and 7 (6.5%) for the DES group (HR 1.21 [0.31–4.67], p = 0.786); for target vessel myocardial infarction, there were 0 (0%) for the DCB group and 7 (6.5%) for the DES group; and for target lesion revascularisation, there were 3 (7.3%) in the DCB group and 9 (8.3%) in the DES group (HR: 0.89 [0.24–3.30]). p = 0.86. These remained not significant after propensity score matching. We found no difference in the mortality outcomes with DCB angioplasty compared to second-generation DES, with a median follow-up of 33 months. DCB can therefore be regarded as a safe option in the treatment of LMS disease in suitable patients. MDPI 2023-02-16 /pmc/articles/PMC9963161/ /pubmed/36826580 http://dx.doi.org/10.3390/jcdd10020084 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gunawardena, Tharusha D.
Corballis, Natasha
Merinopoulos, Ioannis
Wickramarachchi, Upul
Reinhold, Johannes
Maart, Clint
Sreekumar, Sulfi
Sawh, Chris
Wistow, Trevor
Sarev, Toomas
Ryding, Alisdair
Gilbert, Tim J.
Clark, Allan
Vassiliou, Vassilios S.
Eccleshall, Simon
Drug-Coated Balloon vs. Drug-Eluting Stents for De Novo Unprotected Left Main Stem Disease: The SPARTAN-LMS Study
title Drug-Coated Balloon vs. Drug-Eluting Stents for De Novo Unprotected Left Main Stem Disease: The SPARTAN-LMS Study
title_full Drug-Coated Balloon vs. Drug-Eluting Stents for De Novo Unprotected Left Main Stem Disease: The SPARTAN-LMS Study
title_fullStr Drug-Coated Balloon vs. Drug-Eluting Stents for De Novo Unprotected Left Main Stem Disease: The SPARTAN-LMS Study
title_full_unstemmed Drug-Coated Balloon vs. Drug-Eluting Stents for De Novo Unprotected Left Main Stem Disease: The SPARTAN-LMS Study
title_short Drug-Coated Balloon vs. Drug-Eluting Stents for De Novo Unprotected Left Main Stem Disease: The SPARTAN-LMS Study
title_sort drug-coated balloon vs. drug-eluting stents for de novo unprotected left main stem disease: the spartan-lms study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9963161/
https://www.ncbi.nlm.nih.gov/pubmed/36826580
http://dx.doi.org/10.3390/jcdd10020084
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