Lots of interesting abstracts and cases were submitted for TCTAP & AP VALVES 2020 Virtual. Below are accepted ones after thoroughly reviewed by our official reviewers. Don’t miss the opportunity to explore your knowledge and interact with authors as well as virtual participants by sharing your opinion!
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ABS20191118_0004
| Acute Coronary Syndromes (STEMI, NSTE-ACS) | |
| Clinical Safety and Efficacy of Sirolimus Coated Balloon Versus Novel Sirolimus Eluting Stent (DES+DCB) in Treatment of Patients with Acute Coronary Syndrome | |
| Luca Testa1, Sameer Dani2 | |
| IRCCS San Donato Hospital, Italy1, Apollo Hospitals, India2 | |
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Background:
In recent times, Paclitaxel has been a major player for drug coated balloons in interventional field. However, there are safety signals associated with Paclitaxel cytotoxicity. Sirolimus drug is already proven safe and effective when used on drug eluting stent, hence sirolimus-coated balloon (SCB) might constitute an effective alternative to treat coronary atherosclerosis. It may also allow a shorter DAPT duration because of absence of metal. We compared the clinical outcomes of MagicTouch sirolimus-coated balloon and novel drug eluting stent Abluminus DES+ in patients with acute coronary syndrome.
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Methods:
In the present study total 1888 patient presented with ACS as were analyzed. 1671 patients (treated with Abluminus DES+) pooled from en-ABL-e-registry and 217 patients (treated with MagicTouch SCB) pooled from NANOLUTE registry. The two registries were contemporary and real world. 1-yearclinical outcomes were assessed.
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Results:
The baseline characteristics of the patients in both groups were comparable. 1668 (99.8%) and 217 (100%) patients completed 1-yearfollow-up for Abluminus DES+ and MagicTouch SCB. In routine practice, most patients treated with SCB are prescribed minimum 3-months DAPT while patients treated with DES are prescribed with minimum of 12-months DAPT. At 1-year, cumulative MACE rate was reported as 2.6% vs. 5.2%, p=0.05 in DES and DCB groups respectively. There was no statistically significant difference in terms of all cause death (1.1%vs 1.8%, p=0.328), TV-MI (0.5% vs. 0.5%, p=1.000) and cardiac death (1.0% vs.0.0%, p=0.243) between both groups. TLR/TVR accounted for statistically significant difference (1.1% vs. 4.6%, p<0.05). Moreover, 0.7% patients implanted with DES reported with stent thrombosis which was clearly absent in-patients treated with SCB group.
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Conclusion:
Though sirolimus coated balloon, that “leaves nothing behind” is associated with higher restenosis rates when compared to DES patients with ACS, it might be useful in patients with high bleeding risk because of shorter DAPT. Randomized controlled trial is an indispensable tool to further support the results.
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