Drug coated balloon angioplasty in elderly patients with small vessel coronary disease. (December 2015)

• Record Type: Journal Article
• Authors: Sinaga, Dasdo A.; Ho, Hee Hwa; Zeymer, Uwe; Waliszewski, Matthias; Jafary, Fahim H.; Ooi, Yau Wei; Loh, Jason K. K.; Tan, Julian K. B.; Ong, Paul J. L.
• Is Part Of: Therapeutic advances in cardiovascular disease. Volume 9:Number 6(2015:Dec.)
• Page Start: 389
• Page End: 396
• Publication Date: 2015-12
• Subjects: drug coated balloon -- de novo lesion -- small vessel disease -- clinical results -- older patients; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Treatment -- Periodicals; Cardiovascular pharmacology -- Periodicals; Cardiovascular Diseases -- diagnosis -- Periodicals; Cardiovascular Diseases -- therapy -- Periodicals; Cardiovascular Agents -- therapeutic use -- Periodicals; Cardiovascular Diseases -- drug therapy -- Periodicals; Cardiovascular System -- drug effects -- Periodicals; Cardiologie; Hart- en vaatziekten; Appareil cardiovasculaire -- Maladies -- Périodiques; Appareil cardiovasculaire -- Maladies -- Traitement -- Périodiques; Pharmacologie cardiovasculaire -- Périodiques; 616.10605
• DOI: 10.1177/1753944715598714
• Languages: English
• ISSNs: 1753-9447

Abstract

Background: Coronary angioplasty in advanced age is associated with higher rate of comorbidities and complications. Drug coated balloon only angioplasty (DCBA) has emerged as an alternative to treat small vessel coronary disease (SVCD), of reference vessel diameters <2.8 mm, with shorter duration of dual antiplatelet (DAPT). This is the first study to assess the DCBA efficacy in an elderly population with SVCD. Methods and results: We performed a prospective study of 447 patients (334 patients aged <75 and 113 patients aged ⩾75 years old) acquired from the SeQuent Please Small Vessel 'Paclitaxel-Coated Balloon Only' registry. In the older age group, more patients have hypertension (89% versus 77%; p = 0.006), renal insufficiency (21% versus 6%; p < 0.001), atrial fibrillation (17% versus 7%; p = 0.001), and calcified lesions (33% versus 20%; p = 0.006). At 30 days, there was one myocardial infarction requiring target lesion revascularization (TLR) in the younger group. No major adverse cardiac event (MACE) was observed in the older group. At 9 months, the MACE rate in the younger group was 4.2% and 6.1% in the older group ( p = 0.453), with TLR rates at 3.9% and 3.0% ( p = 0.704) respectively. There was no cardiac death observed. Conclusion: DBCA in the elderly with SVCD is as safe and effective compared with younger patients despite more complex anatomy and comorbidities.