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Drug-Eluting Balloons and Drug-Eluting Stents in Diabetic Patients Undergoing Percutaneous Coronary Intervention Due to Restenosis-DM-Dragon Registry.
Niezgoda, Piotr; Kasprzak, Michal; Kubica, Jacek; Kuzma, Lukasz; Januszek, Rafal; Iwanczyk, Sylwia; Tomasiewicz, Brunon; Bil, Jacek; Kowalewski, Mariusz; Jaguszewski, Milosz; Wybraniec, Maciej; Reczuch, Krzysztof; Dobrzycki, Slawomir; Bartus, Stanislaw; Lesiak, Maciej; Gasior, Mariusz; Wolny, Rafal; Witkowski, Adam; Gil, Robert; Cortese, Bernardo; D'Ascenzo, Fabrizio; Wojakowski, Wojciech; Wanha, Wojciech.
Afiliación
  • Niezgoda P; Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Torun, L. Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland.
  • Kasprzak M; Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Torun, L. Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland.
  • Kubica J; Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Torun, L. Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland.
  • Kuzma L; Department of Invasive Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland.
  • Januszek R; Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Cracow University, 30-705 Kraków, Poland.
  • Iwanczyk S; 1st Department of Cardiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
  • Tomasiewicz B; Centre for Heart Disease, Department of Heart Disease, University Hospital Wroclaw, Wroclaw Medical University, 50-556 Wroclaw, Poland.
  • Bil J; Department of Cardiology, National Medical Institute of the Ministry of Interior and Administration, Woloska 137 Str., 02-507 Warsaw, Poland.
  • Kowalewski M; Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 85-094 Bydgoszcz, Poland.
  • Jaguszewski M; Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Woloska 137 Str., 02-507 Warsaw, Poland.
  • Wybraniec M; Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands.
  • Reczuch K; First Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland.
  • Dobrzycki S; First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 40-287 Katowice, Poland.
  • Bartus S; Centre for Heart Disease, Department of Heart Disease, University Hospital Wroclaw, Wroclaw Medical University, 50-556 Wroclaw, Poland.
  • Lesiak M; Department of Invasive Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland.
  • Gasior M; Department of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland.
  • Wolny R; 1st Department of Cardiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
  • Witkowski A; Third Department of Cardiology, Medical University of Silesia, 41-800 Zabrze, Poland.
  • Gil R; Department of Interventional Cardiology and Angiology, National Institute of Cardiology, 04-628 Warsaw, Poland.
  • Cortese B; Department of Interventional Cardiology and Angiology, National Institute of Cardiology, 04-628 Warsaw, Poland.
  • D'Ascenzo F; Department of Cardiology, National Medical Institute of the Ministry of Interior and Administration, Woloska 137 Str., 02-507 Warsaw, Poland.
  • Wojakowski W; Fondazione Ricerca e Innovazione Cardiovascolare, 20143 Milano, Italy.
  • Wanha W; DCB Academy, 20136 Milano, Italy.
J Clin Med ; 13(15)2024 Jul 30.
Article en En | MEDLINE | ID: mdl-39124731
ABSTRACT

Background:

The rate of in-stent restenosis (ISR) is decreasing; however, it is still a challenge for contemporary invasive cardiologists. Therapeutic methods, including drug-eluting balloons (DEBs), intravascular lithotripsy, excimer laser coronary atherectomy, and imaging-guided percutaneous coronary intervention (PCI) with drug-eluting stents (DES), have been implemented. Patients with diabetes mellitus (DM) are burdened with a higher risk of ISR than the general population.

Aims:

DM-Dragon is aimed at evaluating the clinical outcomes of ISR treatment with DEBs vs. DES, focusing on patients with co-existing diabetes mellitus.

Methods:

The DM-Dragon registry is a retrospective study comprising data from nine high-volume PCI centers in Poland. A total of 1117 patients, of whom 473 individuals had DM and were treated with PCI due to ISR, were included. After propensity-score matching (PSM), 198 pairs were created for further analysis. The primary outcome of the study was target lesion revascularization (TLR).

Results:

In DM patients after PSM, TLR occurred in 21 (10.61%) vs. 20 (10.1%) in non-diabetic patients, p = 0.8690. Rates of target vessel revascularization (TVR), target vessel myocardial infarction, device-oriented composite endpoint (DOCE), and cardiac death did not differ significantly. Among diabetic patients, the risk of all-cause mortality was significantly lower in the DEB group (2.78% vs. 11.11%, HR 3.67 (95% confidence interval, CI) [1.01-13.3), p = 0.0483).

Conclusions:

PCI with DEBs is almost as effective as DES implantation in DM patients treated for ISR. In DM-Dragon, the rate of all-cause death was significantly lower in patients treated with DEBs. Further large-scale, randomized clinical trials would be needed to support these findings.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Suiza