A Single-Center, Retrospective, Propensity-Score-Matched Cohort Study Comparing Drug-Coated Balloon Versus Drug-Eluting Stent for Reducing Immediate Post-Procedural Slow-Flow/No-Reflow in Acute ST-Elevation Myocardial Infarction Patients With High Thrombus Burden (STEMI-DCB)
Comparison Of Drug-Coated Balloon Versus Drug-Eluting Stent In STEMI Patients With High Thrombus Burden: A Single-Center Retrospective Study Using Propensity Score Matching
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Contacten en locaties
Studiecontact
Studiecontact
- Naam: Yuan He, MD, PhD
- Telefoonnummer: +86-13991854483
- E-mail: heyuan820927@163.com
Studie Locaties
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Shaanxi
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Xi'an, Shaanxi, China, 710032
- Werving
- First Affiliated Hospital of Fourth Military Medical University
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Contact:
- Yuan He, MD, PhD
- Telefoonnummer: +86-13991854483
- E-mail: heyuan820927@163.com
-
-
Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Bemonsteringsmethode
Studie Bevolking
Beschrijving
Inclusion Criteria:
Patients diagnosed with ST-elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) at this center:
- Symptom onset ≤ 12 hours; OR
- Symptom onset > 12 hours with persistent ischemic symptoms.
- Angiographic thrombus grade of the culprit vessel is G2-G4.
- Reference vessel diameter of the culprit vessel: 2.25-4.0 mm.
- Complete pre-procedural and post-procedural coronary angiographic imaging data are available.
- Age ≥ 18 years old.
Exclusion Criteria:
- Participation in other clinical trials.
- Cardiogenic shock or post-cardiac-arrest resuscitation state.
- Multi-vessel coronary artery disease.
- Severe calcified lesions requiring rotational atherectomy or shock-wave therapy.
- Only compliant or non-compliant plain balloon dilation performed.
- Both DES and DCB applied to the same culprit vessel.
- Culprit lesion located in a coronary bypass graft, or in-stent restenosis / in-stent thrombosis.
- Missing key angiographic or clinical follow-up data.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Aantal groepen / cohorten
Cohorten en interventies
Groep / CohortGroep / Cohort |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
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Drug-Coated Balloon (DCB) Cohort
STEMI patients with high thrombus burden who received drug-coated balloon (DCB) as the final revascularization strategy for culprit coronary vessel
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A drug-coated balloon catheter used for percutaneous coronary intervention in patients with STEMI and high thrombus burden.
The balloon surface is coated with an antiproliferative drug (e.g., paclitaxel) that is transferred to the vessel wall during balloon inflation, inhibiting neointimal hyperplasia.
No permanent metal scaffold is implanted after DCB-only revascularization.
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Drug-Eluting Stent (DES) Cohort
STEMI patients with high thrombus burden who received drug-eluting stent (DES) implantation as the final revascularization strategy for culprit coronary vessel, including bailout DES implantation after DCB.
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A permanent coronary metal scaffold coated with an antiproliferative drug (e.g., sirolimus, everolimus, zotarolimus, or biolimus) implanted during percutaneous coronary intervention.
The stent maintains vessel patency and the eluted drug inhibits neointimal hyperplasia.
Used for culprit-vessel revascularization in STEMI patients with high thrombus burden, including bailout DES implantation after DCB predilation.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Incidence of immediate slow-flow or no-reflow after PCI
Tijdsspanne: Immediately after the index emergency PCI procedure
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The incidence of immediate slow-flow or no-reflow phenomenon after percutaneous coronary intervention (PCI) with either drug-coated balloon (DCB) or drug-eluting stent (DES).
Slow-flow/no-reflow is defined as TIMI flow grade ≤2 after the procedure in the absence of mechanical obstruction, dissection, or severe spasm.
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Immediately after the index emergency PCI procedure
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Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Patient-oriented Composite Endpoint (PoCE) at 1-year follow-up
Tijdsspanne: 1 year after index emergency PCI procedure
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Composite endpoint of all-cause death, non-fatal myocardial infarction, stroke, and any revascularization within 1-year after index emergency PCI.
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1 year after index emergency PCI procedure
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Incidence of Patient-oriented Composite Endpoint (PoCE) at 1-year follow-up
Tijdsspanne: 1 year after index emergency PCI procedure
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The overall incidence of Patient-oriented Composite Endpoint (PoCE) within 1-year after index emergency PCI.
PoCE is defined as a composite of all-cause death, non-fatal myocardial infarction, stroke, and any revascularization.
This endpoint is assessed through in-hospital medical records, outpatient follow-up records, and telephone follow-up data.
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1 year after index emergency PCI procedure
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Individual components of PoCE at 1-year follow-up
Tijdsspanne: 1 year after index emergency PCI procedure
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Incidence of each separate component event of PoCE: all-cause death, non-fatal myocardial infarction, stroke, any revascularization.
This endpoint is assessed through in-hospital medical records, outpatient follow-up records, and telephone follow-up data.
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1 year after index emergency PCI procedure
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Device-oriented Composite Endpoint (DoCE) at 1-year follow-up
Tijdsspanne: 1 year after index emergency PCI procedure
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Composite of cardiac death, target-vessel myocardial infarction (TV-MI), and clinically-driven target-lesion revascularization (CI-TLR) within 1-year after index emergency PCI.
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1 year after index emergency PCI procedure
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Individual components of DoCE at 1-year follow-up
Tijdsspanne: 1 year after index emergency PCI procedure
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Incidence of each separate component event of DoCE: cardiac death, target-vessel myocardial infarction (TV-MI), clinically-driven target-lesion revascularization (CI-TLR).
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1 year after index emergency PCI procedure
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Target Vessel Failure (TVF) at 1-year follow-up
Tijdsspanne: 1 year after index emergency PCI procedure
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Composite of cardiac death, target-vessel myocardial infarction, and clinically-driven target-vessel revascularization within 1-year after index emergency PCI.
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1 year after index emergency PCI procedure
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Clinically-driven target-vessel revascularization at 1-year follow-up
Tijdsspanne: 1 year after index emergency PCI procedure
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Revascularization of target vessel triggered by clinical symptoms or myocardial ischemia evidence within 1-year after index emergency PCI.
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1 year after index emergency PCI procedure
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Net Adverse Clinical Events (NACE) at 1-year follow-up
Tijdsspanne: 1 year after index emergency PCI procedure
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Composite of PoCE plus BARC-defined type 3 or 5 bleeding events within 1-year after index emergency PCI.
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1 year after index emergency PCI procedure
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BARC type 3 or 5 bleeding events at 1-year follow-up
Tijdsspanne: 1 year after index emergency PCI procedure
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Bleeding events meeting BARC (Bleeding Academic Research Consortium) type 3 or type 5 criteria within 1-year after index emergency PCI.
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1 year after index emergency PCI procedure
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Medewerkers en onderzoekers
Sponsor
Sponsor
Publicaties en nuttige links
Algemene publicaties
- Vos NS, Fagel ND, Amoroso G, Herrman JR, Patterson MS, Piers LH, van der Schaaf RJ, Slagboom T, Vink MA. Paclitaxel-Coated Balloon Angioplasty Versus Drug-Eluting Stent in Acute Myocardial Infarction: The REVELATION Randomized Trial. JACC Cardiovasc Interv. 2019 Sep 9;12(17):1691-1699. doi: 10.1016/j.jcin.2019.04.016. Epub 2019 May 21.
- Cenko E, Badimon L, Vadala G, Merkus D, Antoniades C, Collet C, De Maria GL, Djordjevic-Dikic A, Drenjancevic I, Escaned J, Ferreiro JL, Fleming I, Guzik T, Manfrini O, Milicic D, Padro T, Porto I, Riou LM, Ryan N, Tousoulis D, van Beusekom HMM, Vavlukis M, Vilahur G, Zdravkovic M, Duncker DJ, Galassi AR, Bugiardini R; ESC EAPCI Document Reviewers: Gianluca Campo (Italy), and Felix Mahfoud (Switzerland). Pathophysiology, prevention, and management of coronary microvascular obstruction. Eur Heart J. 2026 Aug 14;47(31):4215-4241. doi: 10.1093/eurheartj/ehag334.
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Primaire voltooiing
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Studie voltooiing
Studieregistratiedata
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Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Vaatziekten
- Hart-en vaatziekten
- Pathologische processen
- Hartziekten
- Infarct
- Necrose
- Myocardiale ischemie
- Myocardinfarct
- Ischemie
- Pathologische aandoeningen, tekenen en symptomen
- ST-elevatie myocardinfarct
- Acute kransslagader syndroom
- Apparatuur en benodigdheden
- Prothesen en implantaten
- Stents
- Drugs-eluerende stents
Andere studie-ID-nummers
Andere studie-ID-nummers
- KY20262334-C-1
Plan Individuele Deelnemersgegevens (IPD)
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Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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