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Jiang JL, Huang QJ, Chen MH. Efficacy and safety of drug-coated balloon for de novo lesions of large coronary arteries: Systematic review and meta-analysis of randomized controlled trials. Heliyon 2024; 10:e25264. [PMID: 38333846 PMCID: PMC10850513 DOI: 10.1016/j.heliyon.2024.e25264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/22/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024] Open
Abstract
Background Drug-coated balloon (DCB) is a novel approach to avoiding stent-related complications and has proven effective for the treatment of in-stent restenosis (ISR) and small vessels. However, its role in the treatment of de novo lesions in large vessels is less settled. Aims To estimate the efficacy and safety of drug-coated balloon versus stent in the treatment of de novo lesions in large coronary arteries. Methods We searched the literature until April 2023. We judged the safety of DCB based on major adverse cardiovascular events (MACEs), cardiac death, all-cause mortality, non-fatal myocardial infarction, target lesion revascularization (TLR), and bleeding event; and efficacy according to late lumen loss (LLL), minimum lumen diameter (MLD). We conducted subgroup analyses according to stent type and whether urgent PCI was required. Results A total of 10 RCTs were included. Overall, LLL (mean difference (MD) = -0.19, 95 % confidence interval (CI): -0.32 to -0.06, P = 0.003) was lower in the DCB group than in the Stent arm. This effect was consistent in subgroup analysis regardless of stent type and disease type. In terms of safety indicators, there were no significant differences between DCB and stent. The subgroup analyses found that safety indicators showed no significant differences between DCB and drug-eluting stent (DES), but TLR was lower in the DCB than in the bare metal stent (BMS). Moreover, in ST-elevation myocardial infarction (STEMI), safety indicators and LLL showed no significant differences between DCB and DES, but MLD in the DCB was smaller. While in patients with excluded STEMI, MACE and TLR was lower in the DCB compared with the overall stent. Conclusions DCB could be a promising alternative for treating de novo lesions in large coronary arteries with satisfactory efficacy and low risk, superior to BMS and not inferior to DES, with a trend toward lower late lumen loss.
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Affiliation(s)
- Jin-Li Jiang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, China
| | - Qiao-Juan Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, China
| | - Meng-Hua Chen
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, China
- Department of Intensive Care Unit, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, China
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Wang L, Li X, Li T, Liu L, Wang H, Wang C. Novel application of drug-coated balloons in coronary heart disease: A narrative review. Front Cardiovasc Med 2023; 10:1055274. [PMID: 36937937 PMCID: PMC10017483 DOI: 10.3389/fcvm.2023.1055274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
The incidence of coronary heart disease (CAD) has soared over the years, and coronary intervention has become an increasingly important therapeutic approach. The past decade has witnessed unprecedented developments in therapeutic medical instruments. Given that drug-coated balloons bring many benefits, they are indicated for an increasing number of conditions. In this article, we review the results of current clinical trials about drug-coated balloons and summarize their safety and clinical progression in different coronary artery diseases, laying the groundwork for basic research, and clinical therapeutics of this patient population.
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Affiliation(s)
- Lijin Wang
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Xiaokang Li
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Tian Li
- School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Lin Liu
- Department of Dermatology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Haiyan Wang
- Department of Structural Heart Disease, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- *Correspondence: Haiyan Wang, ; Chiyao Wang,
| | - Chiyao Wang
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- *Correspondence: Haiyan Wang, ; Chiyao Wang,
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Weng R, Liu S, Gu X, Zhong Z. Clonal diversity of the B cell receptor repertoire in patients with coronary in-stent restenosis and type 2 diabetes. Open Life Sci 2021; 16:884-898. [PMID: 34522782 PMCID: PMC8402935 DOI: 10.1515/biol-2021-0091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 05/23/2021] [Accepted: 07/20/2021] [Indexed: 01/01/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is known as a risk factor for coronary in-stent restenosis (ISR) in patients with coronary artery disease (CAD). Evidence suggests that B cells play a functional role in the progression of atherosclerotic lesions. However, the B cell receptor (BCR) repertoire in patients with ISR remains unclear. This study aims to profile the BCR repertoire in patients with coronary ISR/T2DM. A total of 21 CAD patients with or without ISR/T2DM were enrolled. PBMCs were isolated and examined for BCR repertoire profiles using DNA-seq. Our results showed that the diversity of amino acid sequences in ISR DM patients was higher than that in ISR -DM patients. The frequencies of 21 V/J paired genes differed between ISR DM and -ISR DM patients, while frequencies of 5 V/J paired genes differed between ISR DM and ISR -DM. The -ISR -DM group presented the highest clonotype overlap rate, while ISR DM patients presented the lowest overlap rate. Our study presented the BCR repertoires in patients with ISR/T2DM. The data suggested different BCR signatures between patients with ISR and T2DM. Further analysis of BCR profiles would enhance understanding of ISR.
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Affiliation(s)
- Ruiqiang Weng
- Research Experimental Center, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-Sen University, Meizhou 514031, People’s Republic of China
- Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou 514031, People’s Republic of China
- Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou 514031, People’s Republic of China
- Center for Precision Medicine, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou 514031, People’s Republic of China
| | - Sudong Liu
- Research Experimental Center, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-Sen University, Meizhou 514031, People’s Republic of China
- Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou 514031, People’s Republic of China
- Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou 514031, People’s Republic of China
- Center for Precision Medicine, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou 514031, People’s Republic of China
| | - Xiaodong Gu
- Research Experimental Center, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-Sen University, Meizhou 514031, People’s Republic of China
- Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou 514031, People’s Republic of China
- Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou 514031, People’s Republic of China
- Center for Precision Medicine, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou 514031, People’s Republic of China
| | - Zhixiong Zhong
- Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou 514031, People’s Republic of China
- Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou 514031, People’s Republic of China
- Center for Precision Medicine, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou 514031, People’s Republic of China
- Center for Cardiovascular Diseases, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou 514031, People’s Republic of China
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Lozano I, Vegas JM, Rondan J, Segovia E. Percutaneous Intervention in Bifurcations After the DKCRUSH-V Trial. JACC Cardiovasc Interv 2020; 13:141-142. [DOI: 10.1016/j.jcin.2019.10.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 10/25/2022]
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de la Torre Hernández JM, Garcia Camarero T, Lozano Ruiz-Poveda F, Urbano-Carrillo CA, Sánchez Pérez I, Cano-García M, Saez R, Andrés Morist A, Molina E, Pinar E, Torres A, Lezcano EJ, Gutierrez H, Arnold RJ, Zueco J. Angiography and Optical Coherence Tomography Assessment of the Drug-Coated Balloon ESSENTIAL for the Treatment of In-Stent Restenosis. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2019; 21:508-513. [PMID: 31401071 DOI: 10.1016/j.carrev.2019.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/08/2019] [Accepted: 07/18/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study sought to assess the efficacy of the drug-coated balloon (DCB) ESSENTIAL for the treatment of in-stent restenosis (ISR). BACKGROUND DCBs have proven a valid therapeutic option for the management of ISR in several clinical trials, yet no class effect can be claimed. Accordingly, every new DCB model has to be individually evaluated through clinical studies. METHODS This is a prospective, multicenter study including consecutive patients undergoing percutaneous coronary intervention for ISR with the ESSENTIAL DCB. A 6-month quantitative coronary angiography (QCA)/optical coherence tomography (OCT) follow-up was scheduled. The primary endpoint was OCT-derived in-segment maximal area stenosis. Secondary endpoints included QCA-derived in-segment late lumen loss (LLL) and target lesion failure (TLF) rates at 6, 12, and 24 months. TLF was defined as the composite of cardiac death, target vessel myocardial infarction, and target lesion revascularization. RESULTS A total of 31 patients were successfully treated with DCB, with 67% of ISR corresponding to drug-eluting stents (DES). At 6 months, 26 patients underwent the scheduled angiographic follow-up. The mean value for in-segment maximal area stenosis was 51.4 ± 13% and the median value was 53% (IQR 46.4-59.5). In the DES-ISR subgroup, these parameters were 52.6 ± 10% and 55.2% (IQR 49.3-58.5), respectively. In-segment LLL was 0.25 ± 0.43 mm with only 2 (7.7%) patients showing binary restenosis (>50%). The incidence of TLF was 10% at 6 months, 13.3% at 12 months, and 13.3% at 24 months. CONCLUSIONS In this study, the ESSENTIAL DCB showed sustained efficacy in the prevention of recurrent restenosis after treatment of ISR. SUMMARY We sought to assess the efficacy of the drug-coated balloon ESSENTIAL for the treatment of in-stent restenosis through a prospective, multicenter study including QCA and OCT assessment at 6-month follow-up. The primary endpoint was in-segment maximal area stenosis. Among the 31 patients successfully treated with the ESSENTIAL DCB, an angiographic follow-up was conducted in 26. Mean in-segment maximal area stenosis was 51.4 ± 13% and the median value was 53% (IQR 46.4-59.5). In the DES-ISR subgroup, corresponding values were 52.6 ± 10% and 55.2% (IQR 49.3-58.5), respectively. The observed in-segment LLL was 0.25 ± 0.43 mm and binary restenosis rate was 7.7%. TLF was 10% at 6 months and 13.3% at 12 and 24 months.
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Affiliation(s)
| | - Tamara Garcia Camarero
- Hospital Universitario Marques de Valdecilla, Dpt. of Interventional Cardiology, Santander, Spain
| | | | | | - Ignacio Sánchez Pérez
- Hospital Universitario de Ciudad Real, Dpt. of Interventional Cardiology, Ciudad Real, Spain
| | - Macarena Cano-García
- Hospital Regional Universitario Carlos Haya, Dpt. of Interventional Cardiology, Malaga, Spain
| | - Roberto Saez
- Hospital Universitario Basurto, Dpt. of Interventional Cardiology, Bilbao, Spain
| | - Abel Andrés Morist
- Hospital Universitario Basurto, Dpt. of Interventional Cardiology, Bilbao, Spain
| | - Eduardo Molina
- Hospital Universitario Virgen de las Nieves, Dpt. of Interventional Cardiology, Granada, Spain
| | - Eduardo Pinar
- Hospital Universitario Virgen de la Arrixaca, Dpt. of Interventional Cardiology, Murcia, Spain
| | - Alfonso Torres
- Hospital Universitario de Araba, Dpt. of Interventional Cardiology, Vitoria, Spain
| | - Eduardo J Lezcano
- Hospital San Pedro, Dpt. of Interventional Cardiology, Logroño, Spain
| | - Hipolito Gutierrez
- Hospital Clinico de Valladolid, ICICOR/Imaging Core Lab, Valladolid, Spain
| | - Roman J Arnold
- Hospital Clinico de Valladolid, ICICOR/Imaging Core Lab, Valladolid, Spain
| | - Javier Zueco
- Hospital Universitario Marques de Valdecilla, Dpt. of Interventional Cardiology, Santander, Spain
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Cheng Y, Liu DZ, Zhang CX, Cui H, Liu M, Zhang BL, Mei QB, Lu ZF, Zhou SY. Mitochondria-targeted antioxidant delivery for precise treatment of myocardial ischemia–reperfusion injury through a multistage continuous targeted strategy. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2019; 16:236-249. [DOI: 10.1016/j.nano.2018.12.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 11/29/2018] [Accepted: 12/28/2018] [Indexed: 02/06/2023]
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Drug-eluting balloons: an essential tool for contemporary coronary intervention. Coron Artery Dis 2018; 29:526-527. [PMID: 30067579 DOI: 10.1097/mca.0000000000000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Li H, Gui H, Yuan G, Zheng X, Gao C, Yuan H. Increased plasma olfactomedin 2 after interventional therapy is a predictor for restenosis in lower extremity arteriosclerosis obliterans patients. Scandinavian Journal of Clinical and Laboratory Investigation 2018; 78:269-274. [PMID: 29553861 DOI: 10.1080/00365513.2018.1452287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Animal studies have indicated that olfactomedin 2 (OLFM2) is involved in the process of vascular remolding. The aim of the present study was to investigate circulating OLFM2 levels in lower extremity arteriosclerosis obliterans (LEASO) patients and the association of OLFM2 with postoperative restenosis in patients. A total of 203 LEASO patients were enrolled in the present study. Plasma OLFM2 was measured before and 6 h after interventional therapy. After 6 months, patients were divided into a restenosis group and a non-restenosis group. Inter-group and intra-group differences in plasma OLFM2 were compared. The correlation between plasma OLFM2 and the severity of restenosis was analyzed by Spearman's correlation analysis. An receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of plasma OLFM2 on restenosis. Logistic regression was used to determine the risk factors for restenosis. Postoperative OLFM2 in the restenosis group was significantly higher compared with the non-restenosis group (34.07 ± 5.76 ng/mL vs. 19.53 ± 2.99 ng/mL). No significant difference in preoperative plasma OLFM2 levels was identified between the two groups (10.92 ± 2.49 ng/mL vs. 11.54 ± 3.18 ng/mL). Postoperative OLFM2 levels were positively correlated with the severity of restenosis (r = 0.728, p < .001). The area under the ROC curve was 0.902 (95% confidence interval (CI): 0.874-0.965), with a cutoff value of 26.91 ng/mL (95% CI: 26.16-28.32). Plasma OLFM2 was an independent risk factor for restenosis. Our results suggest that plasma OLFM2 is a potential biomarker for restenosis and may be a novel target for the treatment of restenosis.
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Affiliation(s)
- Hongbo Li
- a Department of Vascular Surgery , People's Hospital of Shouguang , Weifang , Shandong , China.,b Department of Vascular Surgery , Shandong Provincial Hospital , Jinan , Shandong , China
| | - Hua Gui
- c Department of Surgery , People's Hospital of Shouguang , Weifang , Shandong , China
| | - Guohong Yuan
- c Department of Surgery , People's Hospital of Shouguang , Weifang , Shandong , China
| | - Xiaomei Zheng
- a Department of Vascular Surgery , People's Hospital of Shouguang , Weifang , Shandong , China
| | - Changkuan Gao
- d Department of Clinical Laboratory , Qilu Hospital , Jinan , Shandong , China
| | - Hai Yuan
- b Department of Vascular Surgery , Shandong Provincial Hospital , Jinan , Shandong , China
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