Early coronary healing in ST segment elevation myocardial infarction : sirolimus-eluting stents vs. drug-coated balloons after bare-metal stents. The PEBSI-2 optical coherence tomography randomized study
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved..
OBJECTIVES: Drug-coated balloons (DCBs) have theoretical advantages over drug-eluting stents (DESs) to facilitate stent healing. We studied whether, in patients undergoing primary coronary interventions (pPCIs), a strategy of DCB after bare-metal stent improves early healing as determined by optical coherence tomography (OCT) compared with new-generation DES.
METHODS: pPCI patients were randomized (1:1) to treatment with new-generation sirolimus-eluting stents (DES group) or DCB-strategy. Vessel healing was assessed by OCT at 90 days.
RESULTS: Fifty-three patients were randomized (26 DES vs. 27 DCB). At 90 days, both strategies showed a low rate of uncovered struts (3.2 vs. 3.2%, P = 0.64) and a very high and similar rate of covered and apposed struts (96.6 vs. 96.1%, respectively; P = 0.58). However, DCB group had a significantly lower rate of major coronary evaginations (68 vs. 37%, P = 0.026), and more frequently developed a thin homogeneous neointimal layer (20 vs. 70.4%, P = 0.001) suggesting distinct superior healing at 3 months compared to DES.
CONCLUSIONS: In pPCI both, sirolimus-DES and DCB-strategy, provide excellent strut coverage at 3 months. However, DCB ensures more advanced and optimal stent healing compared to sirolimus-DES. Further research is needed to determine whether, in patients undergoing pPCI, DCB offers superior long-term clinical and angiographic outcomes than new-generation DES (NCT03610347).
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 |
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| Enthalten in: |
Coronary artery disease - 32(2021), 8 vom: 01. Dez., Seite 673-680 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
García-Touchard, Arturo [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 02.02.2022 Date Revised 09.03.2022 published: Print ClinicalTrials.gov: NCT03610347 Citation Status MEDLINE |
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| doi: |
10.1097/MCA.0000000000001038 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM323818161 |
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| 100 | 1 | |a García-Touchard, Arturo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Early coronary healing in ST segment elevation myocardial infarction |b sirolimus-eluting stents vs. drug-coated balloons after bare-metal stents. The PEBSI-2 optical coherence tomography randomized study |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 02.02.2022 | ||
| 500 | |a Date Revised 09.03.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a ClinicalTrials.gov: NCT03610347 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: Drug-coated balloons (DCBs) have theoretical advantages over drug-eluting stents (DESs) to facilitate stent healing. We studied whether, in patients undergoing primary coronary interventions (pPCIs), a strategy of DCB after bare-metal stent improves early healing as determined by optical coherence tomography (OCT) compared with new-generation DES | ||
| 520 | |a METHODS: pPCI patients were randomized (1:1) to treatment with new-generation sirolimus-eluting stents (DES group) or DCB-strategy. Vessel healing was assessed by OCT at 90 days | ||
| 520 | |a RESULTS: Fifty-three patients were randomized (26 DES vs. 27 DCB). At 90 days, both strategies showed a low rate of uncovered struts (3.2 vs. 3.2%, P = 0.64) and a very high and similar rate of covered and apposed struts (96.6 vs. 96.1%, respectively; P = 0.58). However, DCB group had a significantly lower rate of major coronary evaginations (68 vs. 37%, P = 0.026), and more frequently developed a thin homogeneous neointimal layer (20 vs. 70.4%, P = 0.001) suggesting distinct superior healing at 3 months compared to DES | ||
| 520 | |a CONCLUSIONS: In pPCI both, sirolimus-DES and DCB-strategy, provide excellent strut coverage at 3 months. However, DCB ensures more advanced and optimal stent healing compared to sirolimus-DES. Further research is needed to determine whether, in patients undergoing pPCI, DCB offers superior long-term clinical and angiographic outcomes than new-generation DES (NCT03610347) | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Sirolimus |2 NLM | |
| 650 | 7 | |a W36ZG6FT64 |2 NLM | |
| 700 | 1 | |a Gonzalo, Nieves |e verfasserin |4 aut | |
| 700 | 1 | |a Goicolea, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Gomez-Lara, Josep |e verfasserin |4 aut | |
| 700 | 1 | |a Martín-Yuste, Victoria |e verfasserin |4 aut | |
| 700 | 1 | |a Peral, Vicente |e verfasserin |4 aut | |
| 700 | 1 | |a Martínez-Romero, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Vaquerizo, Beatriz |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez-Recalde, Ángel |e verfasserin |4 aut | |
| 700 | 1 | |a Sarnago, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Oteo, Juan Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Alfonso, Fernando |e verfasserin |4 aut | |
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