Therapeutics Advances
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jun 26, 2015; 7(6): 311-314
Published online Jun 26, 2015. doi: 10.4330/wjc.v7.i6.311
Preliminary experience with drug-coated balloon angioplasty in primary percutaneous coronary intervention
Hee Hwa Ho, Julian Tan, Yau Wei Ooi, Kwok Kong Loh, Than Htike Aung, Nwe Tun Yin, Dasdo Antonius Sinaga, Fahim Haider Jafary, Paul Jau Lueng Ong
Hee Hwa Ho, Julian Tan, Yau Wei Ooi, Kwok Kong Loh, Than Htike Aung, Nwe Tun Yin, Dasdo Antonius Sinaga, Fahim Haider Jafary, Paul Jau Lueng Ong, Department of Cardiology, Tan Tock Seng Hospital, 308433 Singapore, Singapore
Author contributions: Ho HH designed this study, data analysis, data intepretation and writing manuscript; Tan J, Ooi YW, Loh KK, Jafary FH and Ong PJL designed this study, data interpretation; Aung TH, Yin NT and Sinaga DA collected data and data analysis.
Conflict-of-interest: The authors report no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hee Hwa HO, FACC, Department of Cardiology, Tan Tock Seng Hospital, 11, Jalan Tan Tock Seng, 308433 Singapore, Singapore. hokai_wah@yahoo.com
Telephone: +65-63-577831 Fax: +65-63-577772
Received: January 7, 2015
Peer-review started: January 8, 2015
First decision: January 20, 2015
Revised: March 11, 2015
Accepted: April 16, 2015
Article in press: April 20, 2015
Published online: June 26, 2015
Processing time: 168 Days and 16.7 Hours
Abstract

We evaluated the clinical feasibility of using drug-coated balloon (DCB) angioplasty in patients undergoing primary percutaneous coronary intervention (PPCI). Between January 2010 to September 2014, 89 ST-elevation myocardial infarction patients (83% male, mean age 59 ± 14 years) with a total of 89 coronary lesions were treated with DCB during PPCI. Clinical outcomes are reported at 30 d follow-up. Left anterior descending artery was the most common target vessel for PCI (37%). Twenty-eight percent of the patients had underlying diabetes mellitus. Mean left ventricular ejection fraction was 44% ± 11%. DCB-only PCI was the predominant approach (96%) with the remaining 4% of patients receiving bail-out stenting. Thrombolysis in Myocardial Infarction (TIMI) 3 flow was successfully restored in 98% of patients. An average of 1.2 ± 0.5 DCB were used per patient, with mean DCB diameter of 2.6 ± 0.5 mm and average length of 23.2 ± 10.2 mm. At 30-d follow-up, there were 4 deaths (4.5%). No patients experienced abrupt closure of the infarct-related artery and there was no reported target-lesion failure. Our preliminary experience showed that DCB angioplasty in PPCI was feasible and associated with a high rate of TIMI 3 flow and low 30-d ischaemic event.

Keywords: Acute myocardial infarction; Drug coated balloon; Efficacy; Primary angioplasty; Safety

Core tip: Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy for ST-elevation myocardial infarction (STEMI). Stent implantation is considered as a routine during PPCI as it is associated with reduction of ischaemic end-points. Drug-coated balloon (DCB) has emerged as a new therapeutic option to treat coronary artery disease as stent technology has certain limitations. There is however limited data on the feasibility of using DCB as primary therapy in PPCI. We evaluated the clinical safety and efficacy of using paclitaxel-coated balloon in patients undergoing PPCI for STEMI and report on our 30 d clinical outcomes.