Search Results for: Utilizzo degli stent-retriever nell’ictus ischemico acuto

Circulation, Volume 150, Issue Suppl_1, Page A4141761-A4141761, November 12, 2024. Background:Rotational atherectomy has been performed using both radial and femoral access over the years, but there is a lack of consensus on the safety and efficacy of these access sites.Aim:To assess the safety and efficacy of radial access and femoral access.Methods:MEDLINE, Scopus, and Cochrane Library were searched until May 2024 for studies comparing radial approach with femoral approach in patients undergoing rotational atherectomy. The primary outcome was major vascular site bleeding. Secondary outcomes included short-term mortality, long-term mortality, myocardial infarction, major adverse cardiovascular events (MACE), acute stent thrombosis, procedural success, procedural time, hospital stay and radiation exposure. Effect estimates were synthesized using a random-effects model and expressed as risk ratios (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, with corresponding 95% confidence intervals (CIs).Results:13 studies including 13,581 patients with mean age of 60.76 years in the radial group and 66.86 years in the femoral group, who had undergone rotational atherectomy, were included in the analysis. For the outcome of major vascular site bleeding, there was significantly lower risk (RR: 0.25; 95% CI [0.15, 0.43]; p

Circulation, Volume 150, Issue Suppl_1, Page A4137467-A4137467, November 12, 2024. Background:Intravascular ultrasound (IVUS) guidance during percutaneous coronary intervention (PCI) allows better visualization of atherosclerotic plaques than angiography alone. We conducted a systematic review and meta-analysis to comprehensively synthesize the available evidence regarding the efficacy of IVUS-guidance compared to angiography-guided PCI. Moreover, we conducted a sensitivity analysis to determine the applicability of IVUS guidance in complex PCI.Methods:We conducted a comprehensive literature search of major bibliographic databases from inception until May 2024 to identify randomized controlled trials (RCTs) comparing IVUS-guided versus angiography-guided PCI. Risk ratios (RR) with their corresponding 95% confidence intervals (CI) were pooled using the random-effects model, with a p-value

Circulation, Volume 150, Issue Suppl_1, Page A4138792-A4138792, November 12, 2024. Background:Cardiac Allograft Vasculopathy (CAV) is commonly seen in transplanted hearts. Due to the absence of innervation, many transplanted patients have no symptoms despite extensive disease. This poses a challenge in deciding when to perform coronary interventions. We present a case of significant CAV on surveillance angiogram that posed a challenge in management.Case:A 67-year-old female presented for her fifth surveillance coronary angiography nine and a half years after her heart transplant. The angiogram revealed ostial right coronary artery (RCA) chronic total occlusion (CTO) with left-to-right collaterals as well as diffuse irregularities in the left anterior descending (LAD) and left circumflex arteries. The patient was asymptomatic and two years prior to that, her angiogram revealed no significant disease. Biopsies for the past nine years showed no evidence of allograft rejection. She was subsequently referred for coronary intervention.Due to concern of CTO being a sign of rapidly progressing CAV, it was decided to undergo revascularization of the RCA. Antegrade approach was performed with guidance from contralateral injections. Three overlapping drug-eluting stents were deployed proximally-distally using intravascular ultrasound guidance. Surveillance angiography nine months later showed patent RCA stents with no significant disease otherwise. Eighteen months later, angiography demonstrated CTO of the mid LAD and patent RCA stents with mild in-stent restenosis in the most distal RCA stent. The patient remained asymptomatic.Discussion:CAV develops in fifty percent of transplanted hearts within 10 years and requires close surveillance. In this case, revascularization of the RCA CTO resulted in maintaining graft function for at least two additional years as the development of LAD CTO may have resulted in graft failure had the RCA CTO not been intervened upon. CTO revascularization in CAV has the potential to prolong graft viability and delay the need for re-transplantation. Further studies related to CTO revascularization, especially in asymptomatic transplanted patients, are needed to understand the impact on morbidity and mortality in this patient population.

Circulation, Volume 150, Issue Suppl_1, Page A4140268-A4140268, November 12, 2024. Introduction:Cardiac catheterization with percutaneous coronary intervention (PCI) has been the cornerstone of treatment in patients who present with myocardial infarction. Different outcomes have been studied in different patient populations. However, it is unclear if patients with major depressive disorder (MDD) have been receiving the appropriate treatment, or if patients with MDD who undergo PCI have different outcomes compared to the general population.Methods:Sample size was obtained from the National Inpatient Sample (NIS) from 2016 to 2019. We found 1,221,030 hospitalized patients who underwent PCI. These patients were further stratified based on the presence of MDD. A multivariate regression model was used to adjust for confounders and analyze the variables.Results:Only 5,380 (18%) patients with MI and MDD underwent PCI. There was no statistically significant difference regarding in-hospital mortality between patients with MDD who underwent PCI and those who underwent PCI but did not have MDD (2.7% vs. 3%; p=0.49). Patients with MDD who underwent PCI had a higher incidence of cerebrovascular accidents (CVA) compared to those who did not have MDD (1.8% vs 1.4%, p=0.0082). There was a higher incidence of in-stent restenosis (ISR) in patients who had MDD and underwent PCI compared to those who did not have MDD (7.1% vs. 4.9%; p=0.0013). When adjusted for age, comorbidities, gender, and hospital characteristics, patients with MDD had lower mortality than those without MDD with an odds ratio of 0.66.Conclusion:Although patients with MDD presenting with MI are a vulnerable population, it is likely that these patients are not always receiving the appropriate treatment. There is a higher incidence of cardiovascular events such as CVA, ISR, amongst other events. When adjusted for age, comorbidities, gender, and hospital characteristics, patients with MDD had lower mortality than those without MDD.

Circulation, Volume 150, Issue Suppl_1, Page A4144620-A4144620, November 12, 2024. Background:Drug-eluting balloons (DEB) are promising alternatives to drug-eluting stents (DES) for managing de novo coronary artery disease (CAD). Given the scarcity of available data, our objective was to evaluate the outcomes of DES versus DEB in CAD patients.Methods:Databases such as PubMed, Embase, Cochrane Library, and Google Scholar were searched to identify studies comparing clinical outcomes between DCB and DES in de novo CAD patients. Using a random-effects model, pooled estimates of the mean difference (MD) and odds ratio (OR) were calculated along the 95% confidence intervals (CI), with statistical significance set at p

Circulation, Volume 150, Issue Suppl_1, Page A4131445-A4131445, November 12, 2024. Introductions:Pulmonary regurgitation is a diastolic phenomenon but little is known of the impact of RV-PA conduit interventions on RV diastolic function. We measured the acute effects of PPVI or stent implantation on RV diastolic relaxation with high-fidelity pressure catheters.Methods:Right and left heart pressure measurements with Millar Mikro-Cath pressure catheters in children undergoing RV-PA conduit intervention, who had also had an MRI. The relaxation time constant (RV-tau) was calculated as the time constant of the monoexponential pressure decay in the interval between the pressure at dP/dtmin(P0) to when the pressure fell to 10% of P0.Result:The age for PPVI (n=29) or stent (n=21) implantations were (mean ± sd): 14 ± 2.8 and 11.8 ± 4.2 years, respectively. RV-tau decreased 33% in the PPVI group and increased 11% in the Stent group (Table 1). The absolute value of RV dP/dtmindecreased 9% in the Stent but not the PPVI group. The absolute value of LV dP/dtminincreased 12% in the PPVI but not the Stent group. There was a small increase in peak VO2at the last follow-up (median 1.04 years, range 0.15-4.69 years) in the PPVI but not the Stent group compared to baseline (from 27.1 to 31.6 ml/kg/min, p = 0.01). The Δpeak VO2correlated with ΔRV-tau (r = 0.75, p = 0.01, n = 10) but not with ΔRV-PA gradient or pre pulmonary regurgitation fraction.Conclusions:PPVI results in faster RV diastolic relaxation. This may contribute to post-procedure enhanced exercise capacity more than either RV pressure and volume unloading alone.

Circulation, Volume 150, Issue Suppl_1, Page A4146352-A4146352, November 12, 2024. Introduction:Identifying patients at risk for ischemic events after percutaneous coronary intervention (PCI) relies on traditional analysis of limited clinical and imaging variables. Machine learning (ML) has shown promise in effectively predicting cardiovascular risk in population studies. While existing ML models mainly predict mortality and incorporate clinical variables, there is a lack of tools that have utilized genetic data and that predict ischemic events.Aims:This study aims to develop and validate a ML model incorporating genotyping and clinical data to enhance prediction of ischemic outcomes for PCI patients utilizing large prospectively derived diverse datasets.Methods:Patients from the TAILOR-PCI trial (n=5302) were utilized for model development. 50% of the sample was utilized for Boruta feature selection and 50% for training and testing using cross validation. Features included demographics, medical history, medications, PCI characteristics, and genetic data (specifically, CYP2C19 *2, *3, *17 alleles). The primary endpoint was a composite of cardiovascular death, myocardial infarction, stroke, stent thrombosis, and severe recurrent ischemia at 12 months. Multiple ML classification algorithms, including Support Vector Machine (SVM) polynomial, Random Forest, Light gradient boost, XG Boost, among others, were benchmarked for their prediction performance on rare events. The top performing classifiers were externally validated on an independent dataset from the PRECISION PCI study (n=3,745).Results:Mean participant age of the training set was 64.2 ± 11.0 years, with 75.4% being male. During follow-up of 12 months, among 4,572 patients in the entire cohort 343 (7.5%) met the primary outcome. The SVM polynomial model demonstrated the highest area under the curve (AUC) of 0.67 for predicting the primary outcome with test dataset. The sensitivity, specificity, precision, and recall were 0.87, 0.28, 0.07, and 0.87 respectively (Figure). Peripheral arterial disease, body mass index, and age were among the top variables by feature importance.Conclusion:ML models incorporating both clinical and genetic data are feasible and highly promising in predicting major adverse cardiac events that may help guide use of anti-platelet drug therapy. The AUC values are reasonable given imbalances and misclassifications in datasets, and further model optimization with prospective utilization of the model will be paramount.

Circulation, Volume 150, Issue Suppl_1, Page A4145163-A4145163, November 12, 2024. Background:The use of procedural anticoagulation during primary percutaneous coronary intervention (PCI) is well established and has been shown to improve clinical outcomes in patients with ST-elevation myocardial infarction (STEMI). Despite its widespread application in clinical settings, the necessity and efficacy of postprocedural anticoagulation (PPA) remain contentious. Thus, this is the first meta-analysis to assess the efficacy and safety of PPA after PCI for the management of STEMI.Methods:A comprehensive search of PubMed, Cochrane, and Embase databases was conducted to identify studies comparing the clinical outcomes between PPA administration and control (placebo or no anticoagulant infusion) following PCI for STEMI treatment. Statistical analyses were performed using RevMan version 5.4.1, employing a random-effects model to calculate odds ratios (ORs) and their 95% confidence intervals (CIs).Results:A total of four studies comprising 45,066 patients were included (2 RCTs and 2 non-randomized studies), of which 30,925 (68.6%) received PPA. Among the included patients, 35,770 (79.4%) were female. Compared to the control group, PPA did not significantly reduce all-cause mortality (OR 0.82; 95% CI 0.49 – 1.36; P=0.44), cardiac death (OR 0.81; 95% CI 0.49 – 1.33; P=0.41), and major adverse cardiovascular events (MACE) (OR 0.97; 95% CI 0.64 – 1.47; P=0.88; Figure 1A). Moreover, the odds of stent thrombosis (OR 1.24; 95% CI 0.92 – 1.68; P=0.15), myocardial infarction (OR 1.03; 95% CI 0.79 – 1.36; P= 0.81) and stroke (OR 0.95; 95% CI 0.41 – 2.20; P=0.90) did not differ between the groups. However, patients receiving PPA were associated with higher odds of TIMI major/minor bleeding (OR 1.49; 95% CI 1.20 – 1.84; P

Circulation, Volume 150, Issue Suppl_1, Page A4141415-A4141415, November 12, 2024. Lead related venous obstruction (LRVO) is an often underrecognized complication of pacemaker implantation. Symptoms of LRVO may include mild asymmetric upper extremity swelling to highly morbid superior vena cava (SVC) syndrome. We present an unusual case of a 54-year-old man with a history of retained pacemaker leads placed 26 years ago who presents with abdominal distention, lower extremity edema, and shortness of breath. He was found to have new onset ascites and significant pleural effusions. A liver biopsy showed hepatic fibrosis and pleural studies were consistent with chylothorax. After significant workup and diagnostic testing, it was believed that he had late complications often seen in Fontan physiology, notably hepatic fibrosis, lymphatic leakage, and protein losing enteropathy. A venogram and pressure measurements were performed which confirmed obstruction at the junction of the SVC and right atrium with elevated central filling pressures and significant flow through a markedly dilated azygous vein. A lymphangiogram suggested lymphatic leakage through the thoracic duct. An SVC stent was placed in an attempt to relieve the obstruction but the patient had progressive hemodynamic compromise leading to placement of mechanical circulatory support. Ultimately, the patient underwent surgical extraction of the retained pacemaker leads and reconstruction of the superior vena cava and right atrial junction, leading to near-resolution of his symptoms. This unusual presentation of SVC syndrome as a late complication of retained pacemaker leads highlights the potential severity of cardiac implanted electronic device lead-related complications.

Circulation, Volume 150, Issue Suppl_1, Page A4145153-A4145153, November 12, 2024. Introduction:Cardiac cephalgia is an under-recognized type of headache.Description of Case:A 68-year-old female with past medical history of chronic headaches presents with one week of non-radiating central chest pain, exertional dyspnea, palpitations, lightheadedness, and worsening headaches. The headaches were described as a “stabbing and throbbing” pain starting at the vertex and radiating anteriorly. Triggers included stress, and associated symptoms included photophobia and nausea. An electrocardiogram was notable for new T-wave inversions in the inferior leads. An echocardiogram demonstrated an ejection fraction of 44% with regional akinesis of the inferior and inferolateral walls. Patient proceeded for left heart catheterization, which depicted total occlusion of the middle segment of the right coronary artery; a stent was successfully placed and dual antiplatelet therapy was initiated. Following stent placement, she endorsed resolution of her chronic headaches and has not had recurrence.Discussion:This case presents a patient with chronic headaches, initially diagnosed as migraines and occipital neuralgia. She had previously been treated with triptans and botulinum toxin without effect. Resolution of her headaches following revascularization suggest that cardiac cephalgia may be the underlying etiology. Cardiac cephalgia is a secondary headache disorder that is related to cardiac ischemia. It has classically been described as a headache that is triggered by exertion or stress and alleviated by rest or nitrates. Pathophysiology is incompletely understood but current theories include referred pain, simultaneous constriction of cerebral and coronary vessels, reduced cardiac output resulting in increased cardiac pressures and therefore decreased venous return from the brain, and cardiac ischemia-induced neurotransmitter release leading to cerebral vasodilation. The diagnosis of this condition is supported by a temporal relationship between coronary ischemia and headache onset. Interestingly, this patient had a headache onset several months before exhibiting signs of coronary ischemia but had an acute worsening at the time of presentation. It is important to keep cardiac cephalgia on the differential for patients with headaches in order to prevent treatment with agents, such as triptans and ergot derivatives, that are contraindicated in coronary artery disease.

Circulation, Volume 150, Issue Suppl_1, Page A4142867-A4142867, November 12, 2024. Aims:Recurrent in-stent restenosis (RISR) refers to a second event of ISR after successful revascularization procedures of an initial ISR lesion. However, due to its unclear pathogenesis, effective treatment methods are lacking in clinical practice. Therefore, this study aims to investigate the potential mechanisms underlying RISR pathogenesis from an immunological perspective using single-cell RNA sequencing (scRNA-seq), to provide theoretical support for clinical interventions.Methods:Single-cell RNA sequencing was conducted to profile coronary blood mononuclear cells (CBMCs) obtained from 10 patients with recurrent in-stent restenosis (RISR) and 10 control individuals without ISR one year after stent implantation. The potential pathogenic pathway was identified through comprehensive bioinformatics analyses and further validated at the cellular level by isolating monocytes via flow cytometry from the coronary blood of patients in the RISR validation cohort (n=8).Results:RISR altered the proportion of monocyte subtypes, including an increasing trend in FCGR3A+ Monos and a decrease in MHC-II+ Monos. And a marked elevation of activator protein-1 (AP-1) complex within monocytes was identified as key contributor to the unique transcript profile observed in RISR. Evidence at both the RNA and protein levels demonstrated that in RISR patients, CCL5 secreted by T cells can specifically interact with CCR1 of monocytes, thereby upregulating the p38 MAPK/AP-1/inflammatory cytokine axis. Furthermore, co-culture experiments revealed that these monocytes with heightened expression of inflammatory cytokines can indeed promote the proliferation and migration of endothelial cells (EC) and smooth muscle cells (SMC), thus contributing to the occurrence and progression of RISR.Conclusion:Our study provides the first depiction of immunological landscape in the coronary blood of RISR patients. The upregulation of the CCR1/p38 MAPK/AP-1/cytokine axis in monocytes is a critical mechanism that facilitates RISR. Our study fills the gap in the understanding of RISR pathogenesis and holds significant implications for guiding clinical interventions.

Circulation, Volume 150, Issue Suppl_1, Page A4138601-A4138601, November 12, 2024. Background:Antiplatelets are important in ischemic heart disease(IHD) patients. We aim to research the efficacy and safety of single(SAPT), dual(DAPT), and triple(TAPT) antiplatelet approaches in IHD patients undergoing PCI.Methods:A systematic review was conducted until April 1st, 2024, and a network meta-analysis using the Netmeta package in R studio 4.3.3 was performed. Primary outcomes were cardiac death, myocardial infarction(MI), stent thrombosis, stroke, and major bleeding(BARC 3-5). A sensitivity analysis was done to explain variables with high heterogeneity.Results:From 25 studies, a total of 65115 patients were included in the analysis. For cardiac death, 17 studies showed TAPT had a lower risk than DAPT compared to SAPT [RR = 0.74; 95%CI (0.40 to 1.35); p-value = 0.33], [RR = 1.01, 95%CI (0.84 to 1.19); p-value = 0.87] respectively. The heterogeneity was insignificant(I2=0%; p-value=0.58. For MI, 23 studies found TAPT had a lower risk than DAPT compared to SAPT [RR = 0.77; 95%CI (0.51 to 1.16); p-value = 0.2047], [RR = 0.81, 95%CI (0.64 to 1.03); p-value = 0.0850] respectively. The heterogeneity was significant (I2 = 53%). For stent thrombosis, 17 studies showed DAPT had a lower risk than TAPT compared to SAPT [RR = 0.74; 95%CI (0.45 to 1.21); p-value = 0.2284], [RR = 0.84, 95%CI (0.27 to 2.59); p-value = 0.7630] respectively. The heterogeneity in this comparison was significant. For stroke, 17 studies showed DAPT had a lower risk than TAPT for stroke in comparison to SAPT [RR = 0.91; 95%CI (0.75 to 1.10); p-value = 0.3209], and [RR = 0.87, 95%CI (0.43 to 1.76); p-value=0.6937], respectively. The heterogeneity was insignificant(I2=0%; p-value=0.8165). For Major bleeding(BARC 3-5), 15 studies showed DAPT had a lower risk than TAPT in comparison to SAPT[RR = 1.43; 95%CI (1.09 to 1.88); p-value = 0.0107], [RR = 2.78, 95%CI (0.90 to 4.78); p-value = 0.0852] respectively. The heterogeneity was significant(I2 = 49.5%).Conclusion:Personalized treatment approaches that consider the benefits and risks of different antiplatelet strategies are crucial for optimal patient management of IHD.

Circulation, Volume 150, Issue Suppl_1, Page A4145424-A4145424, November 12, 2024. Introduction:Dual therapy with clopidogrel and an anticoagulant has become the standard of care for patients on long-term anticoagulation following PCI. However, the impact of initial triple therapy and the selection of optimal P2Y12 inhibitor on ischemic and bleeding events is ambiguous during the first 30 days after PCI.Aim:Explore prescribing patterns and outcomes of patients discharged on dual therapy versus triple therapy post PCI.Methods:We performed a retrospective chart review of all patients receiving PCI at a single institution over a 12-month time frame who were discharged on an anticoagulant. The exposure variable was type of therapy (dual vs. triple) prescribed at discharge as well as anticoagulants and P2Y12 inhibitors prescribed. The outcome was any 30-day event defined as death, stent thrombosis, major bleeding events, and composites of ischemic and bleeding events. Differences were explored using Fisher’s exact test due to the low number of types of events.Results:The study included 124 patients. 41% patients were treated with immediate dual therapy, and 59% were discharged on triple therapy. A greater proportion of patients undergoing non-elective PCI received triple combination therapy (58% vs 31%; P=0.004; Table 1). There was no statistically significant difference in death or composite outcomes between groups (Table 2). Two stent thrombosis events occurred, both in patients receiving dual antithrombotic therapy with clopidogrel (P=0.09). No stent thrombosis events occurred in patients initially started on triple therapy or in patients receiving dual therapy utilizing a more potent P2Y12 inhibitor. Four major bleeding events were noted in patients on triple therapy, and 1 major bleeding event occurred in a patient on dual therapy (P=0.31; Table 2).Conclusion:In this retrospective analysis of patients, a trend toward higher albeit not statistically significant 30-day stent thrombosis event rate was noted in patients started on dual therapy using clopidogrel for P2Y12 inhibition. These findings should be cautiously interpreted, and analysis is ongoing in a larger dataset to better define the relationship between type of therapy and ischemic and bleeding events.

Circulation, Volume 150, Issue Suppl_1, Page A4137687-A4137687, November 12, 2024. Background:Rotational atherectomy (RA) has been proven to treat coronary artery calcification (CAC) during percutaneous coronary intervention (PCI). Cutting balloons (CBs) are modified balloons (MB).Purpose:We aim to assess the safety and efficacy of RA followed by CB angioplasty (ROTACUT) before stent placement in CAC.Methods:We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies, which were retrieved by systematically searching PubMed, Web of Science, Scopus, and Cochrane through January 2024. We used Stata version 17 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI).Results:We included eight studies with a total of 846 patients. There was no significant difference between ROTACUT and RA + bare balloons in major adverse cardiovascular events (MACE) (RR: 0.60 with 95% CI [0.31, 1.16], P= 0.13), the incidence of cardiac death (RR: 1.32 with 95% CI [0.42, 4.14], P= 0.64), the incidence of target vessel revascularization (TVR) (RR: 1.89 with 95% CI [0.40, 8.84], P= 0.42), the incidence of target lesion revascularization (TLR) (RR: 0.83 with 95% CI [0.39, 1.79], P= 0.64), procedural duration (MD: 0.78 with 95% CI [-4.68, 6.24], P = 0.78), incidence of stent thrombosis (RR: 0.81 with 95% CI [0.22, 2.95], P= 0.75), and the incidence of any procedure-related complications (RR: 0.86 with 95% CI [0.42, 1.75], P= 0.68).Conclusion:ROTACUT and RA + bare balloons demonstrated similar efficacy and safety profiles in terms of MACE, cardiac death, TVR, TLR, procedural duration, stent thrombosis, and all safety outcomes.

Circulation, Volume 150, Issue Suppl_1, Page A4141733-A4141733, November 12, 2024. Background:Lipid-lowering therapy (LLT) is a primary means of secondary prevention in patients with acute coronary syndrome (ACS) and the current guidelines recommend maximum tolerated statin and ezetimibe as LLT. Achilles tendon thickening (ATT) is one of the criteria for the diagnosis of familial hypercholesterolemia, which can sometimes be accompanied by ACS. However, the impact of ATT on the prognosis after ACS under the intensive LLT remains unclear.Hypothesis:ACS patients with ATT would have worse prognosis even with receiving intensive LLT.Aims:The aim of the current study was to compare the long-term prognosis of ACS patients with and without ATT.Methods:We retrospectively analyzed 218 patients who underwent successful percutaneous coronary intervention for ACS and received the intensive LLT with maximum tolerated doses of statins and ezetimibe at our hospital from September 2017 to May 2023. Thickness of Achilles tendon was measured on radiography, and ATT was defined as Achilles tendon ≥8.0 mm in males and ≥7.5 mm in females. The cumulative incidence of 5-year major adverse cardiovascular events (MACE), defined as a composite of cardiac death, spontaneous myocardial infarction, target vessel revascularization, and stent thrombosis, was estimated by the log-rank test and was compared between the patients with and without ATT. Hazard ratio (HR) and 95% confidence interval (CI) of ATT for MACE were estimated through a multivariable Cox model.Results:ATT was found in 58 patients (26.6%). The proportion of low-density lipoprotein cholesterol (LDL-C) < 70 mg/dL was significantly lower in patients with ATT (45% vs. 77%, p

Circulation, Volume 150, Issue Suppl_1, Page A4144631-A4144631, November 12, 2024. Background:The rate of in-stent restenosis (ISR) in clinical practice is approximately 5-10% after 5 years of percutaneous coronary intervention for coronary artery disease. ISR is associated with a high risk of adverse events. The current literature comparing drug-eluting stents (DES) to drug-eluting balloons (DEB) for ISR has yielded divergent results, prompting this meta-analysis.Methods:A comprehensive systematic literature review was conducted across major electronic databases, from inception to May 20, 2024. The search was aimed at identifying studies that compared DCB with DES for ISR. Using an inverse-variance random-effects model, we pooled odds ratios (OR) and mean differences (MD) with their respective 95% confidence intervals (CI). Statistical significance was set at p