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 ORCID: https://orcid.org/0000-0003-2412-2574, Maart, Clint, Sreekumar, Sulfi, Sawh, Chris, Wistow, Trevor, Sarev, Toomas, Ryding, Alisdair, Gilbert, Tim J., Clark, Allan ORCID: https://orcid.org/0000-0003-2965-8941, Vassiliou, Vassilios S. ORCID: https://orcid.org/0000-0002-4005-7752 and Eccleshall, Simon (2023) Drug-coated balloon vs. drug-eluting stents for de novo unprotected left main stem disease: The SPARTAN-LMS study. Journal of Cardiovascular Development and Disease, 10 (2). ISSN 2308-3425

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Abstract

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.

Item Type:	Article
Uncontrolled Keywords:	complex coronary intervention,drug-coated balloon,drug-eluting stent,left main stem,pharmacology, toxicology and pharmaceutics(all),pharmacology (medical) ,/dk/atira/pure/subjectarea/asjc/3000
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	04 Sep 2023 15:30
Last Modified:	19 Oct 2023 03:38
URI:	https://ueaeprints.uea.ac.uk/id/eprint/92980
DOI:	10.3390/jcdd10020084

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