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Research ArticleOriginal Article
Open Access

Clinical outcomes of drug-coated balloon for treatment of de novo coronary artery disease with and without diabetes

Zhaoqian Zhang, Qiang Tan, Jiarui Zhang, Xinhui Wang and Qian Wang
Saudi Medical Journal December 2022, 43 (12) 1347-1353; DOI: https://doi.org/10.15537/smj.2022.43.12.20220534
Zhaoqian Zhang
From the Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Hebei, China.
MD
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  • For correspondence: [email protected]
Qiang Tan
From the Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Hebei, China.
MD, PhD
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Jiarui Zhang
From the Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Hebei, China.
MD
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Xinhui Wang
From the Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Hebei, China.
MD
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Qian Wang
From the Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Hebei, China.
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    Figure 1

    - Major adverse cardiac events (MACE)-tree survival in patient performing drug coasted balloon

Tables

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    Table 1

    - Clinical characteristics of patients with diabetes, pre-diabetes and non-diabetes (N=312).

    Characteristicsdiabetes (n=110)Pre-diabetes (n=48)Non-diabetes (n=154)P-value
    Age62.41±9.8460.51±9.5860.80±9.790.105
    Gender (M/F)66/4433/15113/410.071
    Current smoker47 (42.7)18(37.5)64(41.6)0.826
    Family history23 (20.9)13(27.1)30 (19.5)0.529
    Hypertension51 (46.4)21(43.8)74 (48.1)0.867
    Prior stroke7 (6.4)4 (8.3)9 (6.0)0.828
    Prior myocardial infarction6 (5.5)3 (6.3)7 (4.5)0.880
    LVEF (%)66.09±6.6761.21±9.4565.69±6.980.122
    LVD (mm)47.60±3.9249.46±4.0548.64±4.730.209
    LA (mm)38.26±5.2439.08±7.8136.951±5.850.005
    Clinical presentation0.629
    Stable CHD24729
    Unstable angina6530101
    NSTEMI211124
    TC (mmol/l)4.38±1.134.52±1.134.37±1.020.786
    TG(mmol/l)2.54±1.611.95±0.911.68±0.990.009
    LDL-C(mmol/l)2.45±0.862.52±0.852.44±0.770.894
    HDL-C(mmol/l)1.04±0.211.07±0.231.08±0.230.550
    Creatinine(µmol/l)62.53±15.4264.76±18.8665.72±15.430.370
    Glucose (mmol/l)6.98±2.066.66±0.545.15±0.450.000
    HbA1c (%)6.75±0.926.14±0.195.24±0.350.000
    Urine acid (mmol/l)334.36±89.80332.10±97.24332.16±94.210.987
    HCY (mmol/l)15.79±9.9215.32±7.1718.06±14.720.559
    BMI26.01±3.3825.90±3.0524.96±2.920.065

    Values are presented as number and percentages (%). LVEF: left ventricular ejection fraction, LVD: left ventricular diameter, LA: left arterial diameter, NSTEMI: non-ST segment elevation myocardial infarction, TC: cholesterol, TG: Triglyceride, LDL-C: low density lipoprotein-cholesterol, HDL-C: high-density lipoprotein cholesterol, HCY: homocysteine, BMI: body mass index, HbA1c: hemoglobinA1c, CHD: coronary heart disease

      • View popup
      Table 2

      - Angiographic and procedural characteristics of diabetes, pre-diabetes and non-diabetes patients with DCB (N=312).

      CharacteristicsDiabetes (n=110)Pre-diabetes (n=48)Non-diabetes (n=154)P-value
      Target artery
      Left anterior descending47/110 (42.7)19/48 (39.6)62/154 (40.3)0.900
      Diagonal17/110 (15.5)8/48 (16.7)13/154 (8.4)0.134
      Left circumflex19/110 (17.3)9/48 (18.8)34/154 (22.1)0.614
      Right coronary artery27 /11(27.5)12/48 (25.0)45/154 (29.2)0.664
      Bifurcation31/110 (28.2)13/48 (27.1)51/154 (33.1)0.729
      Multivessel disease61/110 (55.5)25/48 (52.1)79/154 (51.3)0.795
      Number of diseased vessels2.48±0.772.14±0.792.08±0.840.001
      Syntax score12.81±5.3012.95±4.7112.50±4.720.851
      Target lesion
      Reference diameter (mm)2.57±0.212.57±0.242.64±0.190.047
      Lesion length (mm)20.46±9.6017.37±6.8318.49±8.150.042
      Diameter stenosis (%)91.07±7.0190.87±7.3389.68±8.230.271
      Pre-procedure MLD (mm)0.58±0.410.59±0.340.61±0.420.036
      Post-procedure MLD (mm)2.54±0.192.55±0.362.61±0.130.024
      The characteristics of DCB
      Diameter (mm)2.61±0.142.62±0.112.63±0.130.067
      Length (mm)22.53±11.7620.75±10.1520.62±12.410.012

      MLD: minimal luman diameter, DCB: drug-coated balloon

        • View popup
        Table 3

        - Clinical outcomes of diabetes and non-diabetes patients with drug-coated balloon (N=312).

        OutcomesDiabetes (n=110)Pre-diabetes (n=48)Non-diabetes (n=154)P-value
        All cause MACE21 (19.1)6 (12.5)16 (10.4)0.026
        Cardiovascular death1 (0.9)0(0)1 (0.6)0.331
        Non-fatal MI5 (4.5)2(4.2)6 (3.9)0.805
        TLR12 (10.9)4(8.3)7(4.5)0.047
        TVR (including TLR)15(13.6)4(8.3)9 (5.8)0.025

        Values are presented as number andpercenatges (%). MACE: major adverse cardiac events, MI: myocardial infarction, TLR: target lesion revascularization, TVR: target vessel revascularization

          • View popup
          Table 4

          - Clinical characteristics of patients with MACE or without MACE (N=312).

          CharacteristicsMACE group (n=43)Non-MACE (n=269)P-value
          Age61.54 ± 10.8761.21 ±9.660.841
          Gender (M/F)31/12182/870.562
          Current smoker21(48.8)113 (42.0)0.401
          Family history14 (32.6)52 (19.3)0.821
          Hypertension24 (55.8)132 (49.1)0.412
          Prior myocardial infarction5 (11.6)11 (4.1)0.030
          Prior stroke6 (14.0)14 (5.2)0.037
          Diabetes21 (48.8)79 (29.4)0.011
          Pre-diabetes9 (20.9)39 (14.5)0.278
          Clinical presentation0.927
          Stable angina7 (16.3)49 (18.2)
          Unstable angina27 (62.8)169 (62.8)
          NSTEMI9 (20.9)51 (19.0)
          TC (mmol/L)4.33±1.314.43±1.610.681
          TG (mmol/L)2.51±1.611.93±1.590.104
          LDL-C (mmol/L)2.50±1.064.41±0.020.768
          HDL-C (mmol/L)2.37±0.731.93±1.190.942
          Glucose (mmol/L)6.51±1.592.45±0.750.025
          Hemoglobin A1c (%)6.35±0.991.06±0.230.000
          Creatinine (µmol/L)64.92±21.435.94±1.530.872
          Urine acid341.82±133.565.83±0.880.585
          HCY (mmol/L)16.56±7.2855.18±15.270.833
          Body mass index26.07± 3.49331.39±84.380.198
          LVD (mm)48.68 ± 4.6748.42±4.410.759
          LAD (mm)39.30±8.0137.70±5.790.185
          LVEF (%)64.65±9.7865.25±6.700.625
          Target artery
          Left anterior descending11(25.6)117 (43.5)0.027
          Diagnal7(16.3)31 (11.5)0.295
          Left circumflex artery6(14.0)56 (20.8)0.376
          Right coronary artery19(44.2)65 (24.2)0.006
          Bifurcation25 (58.1)70 (26.0)0.000
          Multivessel disease31 (72.1)134 (49.8)0.007
          Number of diseased vessel2.67±0.712.16±0.820.000
          Syntax score16.18±4.4512.07±4.820.000
          Target lesion
          Reference diameter (mm)2.68±0.152.71±0.210.475
          Lesion length (mm)21.46±8.8018.64±8.460.049
          Diameter stenosis (%)92.93±6.1490.01±7.780.019
          Pre-procedure MLD (mm)0.58±0.150.59±0.160.738
          Post-procedure MLD (mm)2.49±0.192.48±0.240.692
          The characteristics of DES
          Diameter (mm)2.62±0.212.61±0.210.729
          Length (mm)26.51±12.8921.81±11.570.016

          LVEF: left ventricular ejection fraction, LVD: left ventricular diameter, LAD: left arterial diameter, NSTEMI: non-ST segment elevation myocardial infarction, TC: cholesterol, TG: Triglyceride, LDL-C: low density lipoprotein-cholesterol, HDL-C: high-density lipoprotein cholesterol, HCY: homocysteine, MLD: minimal luman diameter, DCB: drug-coated balloon, MACE: major adverse cardiac events, DES: drug-eluting stents, M/F: male/female

            • View popup
            Table 5

            - Proportional hazards model regression of major adverse events in patients undergoing PCI with DCB.

            CharacteristicsUnivariate analysis Coefficient (95% CI)P-valueMultiple analysis Coefficient (95% CI)P-value
            Diabetes2.348 (1.142-4.829)0.0202.049 (1.056-4.284)0.047
            Pre-diabetes1.560 (0.542-4.490)0.560------
            Bifurcation5.265 (3.077-9.066)0.0005.255 (2.765-9.986)0.000
            Syntax score1.138 (1.089-1.189)0.0001.098 (1.040-1.559)0.001
            DCB length1.033 (1.015-1.050)0.0111.028 (1.006-1.051)0.072
            DCB diameter1.475 (0.277-7.860)0.646------
            Post MLD1.138 (0.350-3.703)0.829------
            Reference diameter0.606 (0.143-2.577)0.0591.730 (0.4545-4.393)0.422
            Lesion length1.041(1.014-1.069)0.0021.870(1.202-2.909)0.076
            BMI1.064 (0.960-1.179)0.238------
            Glucose1.153 (1.002-1.327)0.0461.103 (1.001-1.377)0.151
            Hemoglobin A1c1.522 (1.190-1.948)0.0011.084 (1.160-1.741)0.014
            Number of vessel diseased2.793 (1.937-4.033)0.0001.321 (0.864-2.081)0.198
            Age0.993 (0.959-1.129)0.711------
            Hypertension1.135 (0.571-2.038)0.139------
            Smoke1.131 (0.570-2.245)0.724-------
            Prior MI0.950 (0.670-1.348)0.775------
            LDL-C1.018 (0.656-1.580)0.936-------

            DCB: durg-coated balloon, Post MLD: post-procesure minimal luman diameter, LDL-C: low density lipoprotein-cholesterol, MI: myocardial infarction

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            Clinical outcomes of drug-coated balloon for treatment of de novo coronary artery disease with and without diabetes
            Zhaoqian Zhang, Qiang Tan, Jiarui Zhang, Xinhui Wang, Qian Wang
            Saudi Medical Journal Dec 2022, 43 (12) 1347-1353; DOI: 10.15537/smj.2022.43.12.20220534

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            Clinical outcomes of drug-coated balloon for treatment of de novo coronary artery disease with and without diabetes
            Zhaoqian Zhang, Qiang Tan, Jiarui Zhang, Xinhui Wang, Qian Wang
            Saudi Medical Journal Dec 2022, 43 (12) 1347-1353; DOI: 10.15537/smj.2022.43.12.20220534
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            • drug-coated balloon
            • percutaneous coronary intervention
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