Successful or Uncomplicated Use of Drug‐Coated Balloon Versus Drug‐Eluting Stent Strategies for De Novo Culprit Lesions in Acute Coronary Syndromes: Insights from a Nationwide Registry in Japan

作者：T Takahashi, Kyohei Yamaji, Shun Kohsaka, Hideki Ishii, Yuichiro Mori, Yuetsu Kikuta, Tetsuzo Wakatsuki, Koji Yamaguchi, Daisuke Nishioka, Kenya Kusunose, Tetsuya Amano, Masataka Sata, Ken Kozuma, Shiro Uemura, Yutaka Hikichi, Osamu Iida, Yuji Ikari, Koichi Kaikita, Yoshio Kobayashi, Toshiro Shinke, Shinjo Sonoda, Saeko Takahashi, Kiyoshi Hibi, Yuichiro Maekawa, Shinichiro Yamada, Tetsuya Amano, Shun Kohsaka, Osamu Iida, Hideki Ishii, Kenichi Sakakura, Toshiro Shinke, Masato Nakamura, Tetsuya Matoba, Shun Kohsaka, Hideki Ishii, Kyohei Yamaji, Hirohiko Ando, Ayako Kunimura, Kenichi Sakakura, Takahiro Suzuki, Yuichiro Mori, Hideki Wada, Shun Kohsaka, Hideki Ishii, Kazuyuki Ozaki, Yuetsu Kikuta, Hiroyuki Kunii, Syoichi Kuramitsu, Mitsuaki Sawano, Jun Takahashi, Toshiharu Takeuchi, Yohei Numasawa, Tetsuya Matoba, Kyohei Yamaji, Tetsu Watanabe · 发表于：Journal of the American Heart Association · 年份：2025 · DOI：10.1161/jaha.124.038071 · 被引用次数：7 · 研究领域：Coronary Interventions and Diagnostics、Acute Myocardial Infarction Research、Cardiac Imaging and Diagnostics

BACKGROUND: Randomized trials demonstrated that drug-coated balloon (DCB) was not inferior to drug-eluting stent (DES) for acute coronary syndrome (ACS). However, generalizability in clinical settings remains unclear. The present study compared the outcomes of DCB and DES strategies in percutaneous coronary intervention for ACS within a nationwide procedure-based registry. METHODS AND RESULTS: This was a retrospective analysis of a cohort study from a prospective, nationwide registry between January 2017 and December 2020 in Japan, focusing on patients with ACS who underwent DCB or DES for a single de novo lesion. Patients who required bailout stenting after treatment with DCB were excluded from the analysis. The 1-year incidence of all-cause mortality, cardiovascular death, noncardiovascular death, nonfatal ACS, stroke, and major bleeding events was compared. A subgroup analysis included lesion-based and ST-elevation myocardial infarction/non-ST-elevation ACS stratifications. Among 5212 propensity score-matched patients with ACS, no significant differences were observed in the 1-year incidence of all-cause mortality (4.5% versus 4.6%, hazard ratio [HR], 0.92 [95% CI, 0.72-1.19]); cardiovascular death (2.5% versus 2.5%, HR, 0.90 [95% CI, 0.64-1.26]); noncardiovascular death (2.0% versus 2.1%, HR, 0.96 [95% CI, 0.65-1.42]); or nonfatal ACS (1.7% versus 2.0%, HR, 1.04 [95% CI, 0.70-1.54]) between DCB and DES. DCB was associated with a higher incidence of stroke (0.8% versus 0.3...