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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)

3. september 2026 oppdatert av: Yuan He, MD, Xijing Hospital

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

This is a single-center, retrospective, propensity-score-matched observational study. It aims to compare the rate of immediate slow-flow or no-reflow after percutaneous coronary intervention (PCI) between drug-coated balloon (DCB) and drug-eluting stent (DES) in STEMI patients with high thrombus burden. Medical records of eligible patients admitted between January 1, 2019 and June 30, 2025 will be reviewed. Propensity-score matching will be used to balance baseline characteristics of the two groups. Both procedural-related outcomes and 1-year clinical follow-up events will be analyzed.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Studietype

Observasjonsmessig

Registrering (Antatt)

668

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

  • Kina
    • Shaanxi
      • Xi'an, Shaanxi, Kina, 710032
        • Rekruttering
        • First Affiliated Hospital of Fourth Military Medical University
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

This is a single-center retrospective observational study. The study population consists of patients diagnosed with ST-elevation myocardial infarction (STEMI) with high thrombus burden (angiographic thrombus grade G2-G4) who underwent emergency percutaneous coronary intervention (PCI) at Xijing Hospital between January 1, 2019 and June 30, 2025. Eligible patients received either drug-coated balloon (DCB) or drug-eluting stent (DES) as the final revascularization strategy for the culprit vessel. Patients are identified from in-hospital medical records and coronary angiographic databases.

Beskrivelse

Inclusion Criteria:

  1. 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.
  2. Angiographic thrombus grade of the culprit vessel is G2-G4.
  3. Reference vessel diameter of the culprit vessel: 2.25-4.0 mm.
  4. Complete pre-procedural and post-procedural coronary angiographic imaging data are available.
  5. Age ≥ 18 years old.

Exclusion Criteria:

  1. Participation in other clinical trials.
  2. Cardiogenic shock or post-cardiac-arrest resuscitation state.
  3. Multi-vessel coronary artery disease.
  4. Severe calcified lesions requiring rotational atherectomy or shock-wave therapy.
  5. Only compliant or non-compliant plain balloon dilation performed.
  6. Both DES and DCB applied to the same culprit vessel.
  7. Culprit lesion located in a coronary bypass graft, or in-stent restenosis / in-stent thrombosis.
  8. Missing key angiographic or clinical follow-up data.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
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
Enhet: Drug-Coated Balloon (DCB)
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.
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.
Enhet: Drug-Eluting Stent (DES)
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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Incidence of immediate slow-flow or no-reflow after PCI
Tidsramme: Immediately after the index emergency PCI procedure
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.
Immediately after the index emergency PCI procedure

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Patient-oriented Composite Endpoint (PoCE) at 1-year follow-up
Tidsramme: 1 year after index emergency PCI procedure
Composite endpoint of all-cause death, non-fatal myocardial infarction, stroke, and any revascularization within 1-year after index emergency PCI.
1 year after index emergency PCI procedure
Incidence of Patient-oriented Composite Endpoint (PoCE) at 1-year follow-up
Tidsramme: 1 year after index emergency PCI procedure
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.
1 year after index emergency PCI procedure
Individual components of PoCE at 1-year follow-up
Tidsramme: 1 year after index emergency PCI procedure
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.
1 year after index emergency PCI procedure
Device-oriented Composite Endpoint (DoCE) at 1-year follow-up
Tidsramme: 1 year after index emergency PCI procedure
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.
1 year after index emergency PCI procedure
Individual components of DoCE at 1-year follow-up
Tidsramme: 1 year after index emergency PCI procedure
Incidence of each separate component event of DoCE: cardiac death, target-vessel myocardial infarction (TV-MI), clinically-driven target-lesion revascularization (CI-TLR).
1 year after index emergency PCI procedure
Target Vessel Failure (TVF) at 1-year follow-up
Tidsramme: 1 year after index emergency PCI procedure
Composite of cardiac death, target-vessel myocardial infarction, and clinically-driven target-vessel revascularization within 1-year after index emergency PCI.
1 year after index emergency PCI procedure
Clinically-driven target-vessel revascularization at 1-year follow-up
Tidsramme: 1 year after index emergency PCI procedure
Revascularization of target vessel triggered by clinical symptoms or myocardial ischemia evidence within 1-year after index emergency PCI.
1 year after index emergency PCI procedure
Net Adverse Clinical Events (NACE) at 1-year follow-up
Tidsramme: 1 year after index emergency PCI procedure
Composite of PoCE plus BARC-defined type 3 or 5 bleeding events within 1-year after index emergency PCI.
1 year after index emergency PCI procedure
BARC type 3 or 5 bleeding events at 1-year follow-up
Tidsramme: 1 year after index emergency PCI procedure
Bleeding events meeting BARC (Bleeding Academic Research Consortium) type 3 or type 5 criteria within 1-year after index emergency PCI.
1 year after index emergency PCI procedure

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Xijing Hospital

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. januar 2019

Primær fullføring (Antatt)

30. juni 2027

Studiet fullført (Antatt)

31. januar 2028

Datoer for studieregistrering

Først innsendt

1. september 2026

Først innsendt som oppfylte QC-kriteriene

3. september 2026

Først lagt ut (Faktiske)

8. september 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

8. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

3. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • KY20262334-C-1

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

Individual-level patient data will not be shared due to patient privacy protection requirements and local hospital data management regulations. This is a single-center retrospective study based on historical medical records. No formal data sharing mechanism has been established. Aggregated study results may be published in peer-reviewed journals.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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