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Wearable Cardioverter-Defibrillator Therapy for the Prevention of Sudden Cardiac Death A Systematic Review and Meta-Analysis A Randomized Trial of a 1-Hour Troponin T Protocol in Suspected Acute Coronary Syndromes: The Rapid Assessment of Possible ACS In the Emergency Department with High Sensitivity Troponin T (RAPID-TnT) Study Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients Fourth Universal Definition of Myocardial Infarction (2018) Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association Current Interventions for the Left Main Bifurcation Investigating methotrexate toxicity within a randomized double-blinded, placebo-controlled trial: Rationale and design of the Cardiovascular Inflammation Reduction Trial-Adverse Events (CIRT-AE) Study One or two stents for the distal Left Main bifurcation The DK crush V study - The DK crush V study 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC) Progression of Device-Detected Subclinical Atrial Fibrillation and the Risk of Heart Failure

Clinical Trial2018 Aug 11.[Epub ahead of print]

JOURNAL:Int Heart J. Article Link

The Comparison of Clinical Outcomes After Drug-Eluting Balloon and Drug-Eluting Stent Use for Left Main Bifurcation In-Stent Restenosis

Lee WC, Hsueh SK, Chen CJ et al. Keywords: Cardiovascular mortality; Percutaneous coronary intervention; Recurrent myocardial infarction; Target lesion revascularization

ABSTRACT


Increasing evidence is available for the use of percutaneous coronary intervention (PCI) in selected patients with unprotected left main (LM) bifurcation coronary lesions. However, little data have been reported on recurrent in-stent restenosis (ISR) for LM bifurcation lesions. The aim of this study was to evaluate the efficacy of a drug-eluting balloon (DEB) for LM bifurcation ISR compared with that of a drug-eluting stent (DES).Between December 2011 and December 2015, 104 patients who underwent PCI for unprotected LM bifurcation ISR were enrolled. We separated the patients into 2 groups: (1) those underwent PCI with further DEB and (2) those underwent PCI with further DES. Clinical outcomes were analyzed.Patients' average age was 67.14 ± 7.65 years, and the percentage of male patients was 76.0%. A total of 75 patients were enrolled in the DEB group, and another 29 patients were enrolled in the DES group. Similar target lesion revascularization (TLR) rate and recurrent myocardial infarction (MI) rate were noted for both groups. A significantly higher cardiovascular mortality rate was found in the DES group (10.7% versus 0%, P = 0.020), and a higher all-cause mortality rate was noted in the DES group (21.4% versus 6.8%, P = 0.067).It is feasible to use DEB for LM bifurcation ISR. When comparing DEB with DES, similar TLR rates were found, but lower recurrent MI and lower cardiovascular death were noted for DEB treatment.