Combined analysis of two parallel randomized trials of sirolimus-coated and paclitaxel-coated balloons in coronary in-stent restenosis lesions
Background: Paclitaxel-coated balloons (PCBs) are a preferred treatment option for coronary in-stent restenosis. To date, data from randomized trials of alternative drug coatings are lacking. The aim of the randomized Malaysian and German-Swiss randomized trials was to investigate a novel sirolimus-...
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my.um.eprints.404272024-07-15T08:02:45Z http://eprints.um.edu.my/40427/ Combined analysis of two parallel randomized trials of sirolimus-coated and paclitaxel-coated balloons in coronary in-stent restenosis lesions Scheller, Bruno Mangner, Norman Kader, Muhamad Ali S. K. Abdul Ahmad, Wan Azman Wan Jeger, Raban Wohrle, Jochen Ong, Tiong Kiam Liew, Houng Bang Gori, Tommaso Mahfoud, Felix Nuruddin, Amin Ariff Woitek, Felix Abidin, Imran Zainal Schwenke, Carsten Schnorr, Beatrix Ali, Rosli Mohd R Medicine (General) Background: Paclitaxel-coated balloons (PCBs) are a preferred treatment option for coronary in-stent restenosis. To date, data from randomized trials of alternative drug coatings are lacking. The aim of the randomized Malaysian and German-Swiss randomized trials was to investigate a novel sirolimus-coated balloon (SCB) compared with a PCB in in-stent restenosis. Methods: One hundred one patients with drug-eluting stent in-stent restenosis were enrolled in 2 identical randomized trials comparing the novel SCB (SeQuent SCB, 4 mu g/mm(2)) with the clinically proven PCB (SeQuent Please, 3 mu g/mm(2)). Primary end point was angiographic late lumen loss at 6 months. Secondary end points included procedural success, major adverse cardiac events, and individual clinical end points such as stent thrombosis, cardiac death, target lesion myocardial infarction, clinically driven target lesion revascularization, and binary restenosis. Results: Quantitative coronary angiography revealed no differences in baseline parameters. After 6 months, in-segment late lumen loss was 0.250.57 mm in the PCB group versus 0.260.60 mm in the SCB group. Mean difference between SCB and PCB was 0.01 (95% CI, -0.23 to 0.24). Noninferiority at a predefined margin of 0.35 was shown. Clinical events up to 12 months did not differ between the groups. Conclusions: This first-in man comparison of a novel SCB with a crystalline coating showed similar angiographic and clinical outcomes in the treatment of coronary drug-eluting stent in-stent restenosis compared with PCB. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02996318, NCT03242096. Lippincott Williams & Wilkins 2022-09 Article PeerReviewed Scheller, Bruno and Mangner, Norman and Kader, Muhamad Ali S. K. Abdul and Ahmad, Wan Azman Wan and Jeger, Raban and Wohrle, Jochen and Ong, Tiong Kiam and Liew, Houng Bang and Gori, Tommaso and Mahfoud, Felix and Nuruddin, Amin Ariff and Woitek, Felix and Abidin, Imran Zainal and Schwenke, Carsten and Schnorr, Beatrix and Ali, Rosli Mohd (2022) Combined analysis of two parallel randomized trials of sirolimus-coated and paclitaxel-coated balloons in coronary in-stent restenosis lesions. Circulation-Cardiovascular Interventions, 15 (9). ISSN 1941-7632, DOI https://doi.org/10.1161/CIRCINTERVENTIONS.122.012305 <https://doi.org/10.1161/CIRCINTERVENTIONS.122.012305>. https://doi.org/10.1161/CIRCINTERVENTIONS.122.012305 10.1161/CIRCINTERVENTIONS.122.012305 |
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R Medicine (General) Scheller, Bruno Mangner, Norman Kader, Muhamad Ali S. K. Abdul Ahmad, Wan Azman Wan Jeger, Raban Wohrle, Jochen Ong, Tiong Kiam Liew, Houng Bang Gori, Tommaso Mahfoud, Felix Nuruddin, Amin Ariff Woitek, Felix Abidin, Imran Zainal Schwenke, Carsten Schnorr, Beatrix Ali, Rosli Mohd Combined analysis of two parallel randomized trials of sirolimus-coated and paclitaxel-coated balloons in coronary in-stent restenosis lesions |
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Background: Paclitaxel-coated balloons (PCBs) are a preferred treatment option for coronary in-stent restenosis. To date, data from randomized trials of alternative drug coatings are lacking. The aim of the randomized Malaysian and German-Swiss randomized trials was to investigate a novel sirolimus-coated balloon (SCB) compared with a PCB in in-stent restenosis. Methods: One hundred one patients with drug-eluting stent in-stent restenosis were enrolled in 2 identical randomized trials comparing the novel SCB (SeQuent SCB, 4 mu g/mm(2)) with the clinically proven PCB (SeQuent Please, 3 mu g/mm(2)). Primary end point was angiographic late lumen loss at 6 months. Secondary end points included procedural success, major adverse cardiac events, and individual clinical end points such as stent thrombosis, cardiac death, target lesion myocardial infarction, clinically driven target lesion revascularization, and binary restenosis. Results: Quantitative coronary angiography revealed no differences in baseline parameters. After 6 months, in-segment late lumen loss was 0.250.57 mm in the PCB group versus 0.260.60 mm in the SCB group. Mean difference between SCB and PCB was 0.01 (95% CI, -0.23 to 0.24). Noninferiority at a predefined margin of 0.35 was shown. Clinical events up to 12 months did not differ between the groups. Conclusions: This first-in man comparison of a novel SCB with a crystalline coating showed similar angiographic and clinical outcomes in the treatment of coronary drug-eluting stent in-stent restenosis compared with PCB. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02996318, NCT03242096. |
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Scheller, Bruno Mangner, Norman Kader, Muhamad Ali S. K. Abdul Ahmad, Wan Azman Wan Jeger, Raban Wohrle, Jochen Ong, Tiong Kiam Liew, Houng Bang Gori, Tommaso Mahfoud, Felix Nuruddin, Amin Ariff Woitek, Felix Abidin, Imran Zainal Schwenke, Carsten Schnorr, Beatrix Ali, Rosli Mohd |
author_facet |
Scheller, Bruno Mangner, Norman Kader, Muhamad Ali S. K. Abdul Ahmad, Wan Azman Wan Jeger, Raban Wohrle, Jochen Ong, Tiong Kiam Liew, Houng Bang Gori, Tommaso Mahfoud, Felix Nuruddin, Amin Ariff Woitek, Felix Abidin, Imran Zainal Schwenke, Carsten Schnorr, Beatrix Ali, Rosli Mohd |
author_sort |
Scheller, Bruno |
title |
Combined analysis of two parallel randomized trials of sirolimus-coated and paclitaxel-coated balloons in coronary in-stent restenosis lesions |
title_short |
Combined analysis of two parallel randomized trials of sirolimus-coated and paclitaxel-coated balloons in coronary in-stent restenosis lesions |
title_full |
Combined analysis of two parallel randomized trials of sirolimus-coated and paclitaxel-coated balloons in coronary in-stent restenosis lesions |
title_fullStr |
Combined analysis of two parallel randomized trials of sirolimus-coated and paclitaxel-coated balloons in coronary in-stent restenosis lesions |
title_full_unstemmed |
Combined analysis of two parallel randomized trials of sirolimus-coated and paclitaxel-coated balloons in coronary in-stent restenosis lesions |
title_sort |
combined analysis of two parallel randomized trials of sirolimus-coated and paclitaxel-coated balloons in coronary in-stent restenosis lesions |
publisher |
Lippincott Williams & Wilkins |
publishDate |
2022 |
url |
http://eprints.um.edu.my/40427/ https://doi.org/10.1161/CIRCINTERVENTIONS.122.012305 |
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1805881119235637248 |
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13.19449 |