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Most studies evaluating the benefit and risk of additional ballooning (AB) after stent implantation have involved patients (pts) with stable angina. However, its safety and efficacy may be questionable in the context of pts presenting with acute myocardial infarction (AMI). We evaluated the 12-month clinical outcomes of AMI pts who was treated with drug-eluting stents (DES) and subsequent AB.
A total of 1618 AMI patients in the Korea transradial intervention (TRI) registry, a retrospective multicenter registry with 4890 pts who underwent percutaneous coronary intervention (PCI) in 2009 at 9 centers were grouped according to additional ballooning (AB; N=814) and non-additional ballooning (Non-AB; N=804) after DES implantation. We compared TVR-MACE defined as composite of total mortality, any myocardial infarction (MI), target vessel revascularization (TVR) at 12 months between the two groups.
After baseline adjustment using 1:1 propensity score stratification, the incidence of TVR-MACE at 12 month follow up was similar between the two groups. Despite of similar incidence of myocardial infarction (0.9% vs 1.6%; p=0.363) and TVR (3.8% vs 5.7%; p=0.195) between the two groups, however, the AB group was associated with higher mortality (5.0% vs 2.4%; hazard ratio 2.15; 95% confidence interval 1.01 to 4.57; p=0.044).
In pts with AMI, overall clinical outcomes of AB following DES implantation could be similar with those of Non-AB up to 12 months, however AB could be associated with significantly higher total mortality, needs further extensive study with larger study population to get a final conclusion.