Fondazione RIC

Uniti dalla fiducia per la ricerca

Progetto: Gestione a distanza dello scompenso cardiaco

2025

This post hoc analysis of the EASTBOURNE Registry examined how drug-coated balloons (DCBs), specifically sirolimus-coated balloons, perform in patients of different ethnic backgrounds—comparing clinical outcomes between East Asian and Caucasian populations with coronary artery disease.
Drawing from over 2,000 patients treated across 38 international centers, the study used matched groups to ensure a fair comparison. While both groups had similar overall health profiles after matching, procedural practices and outcomes differed. Caucasian patients had higher rates of repeat treatment at the original lesion (target lesion revascularization), while East Asian patients experienced higher rates of bleeding. Other key outcomes such as heart attacks and mortality were similar between the two groups.
These findings suggest that ethnicity may play a role in how patients respond to DCB treatment, emphasizing the importance of personalized approaches in interventional cardiology.
.


020_AIJ-D-24-00044_ElKhoury-1

DOWNLOAD PDF


The ANDROMEDA study is a meta-analysis comparing 3-year clinical outcomes of paclitaxel-coated balloon (PCB) angioplasty and drug-eluting stent (DES) implantation for small-vessel coronary artery disease (SV-CAD).
The study combined individual patient data from three randomized trials involving 1154 patients and 1360 lesions. The results indicated that at 3 years, PCB showed a lower risk of major adverse cardiac events (MACE) compared to DES (HR 0.67, 95% CI 0.47–0.96). However, there were no significant differences in target lesion failure (TLF) between the two groups. The analysis also showed consistent results when including data from a fourth trial.
These findings provide valuable insights into the comparative long-term outcomes of PCB and DES for treating SV-CAD.



DOWNLOAD PDF


The Preventive PCI-VP Study is a narrative review exploring the evolving role of preventive percutaneous coronary intervention (PCI) for vulnerable coronary plaques—non-obstructive lesions that may precipitate acute coronary syndromes and sudden cardiac death. These plaques, often thin-cap fibroatheromas with large lipid cores and thin fibrous caps, are typically undetectable via standard coronary angiography.
The paper highlights the value of high-resolution intravascular imaging (e.g., OCT and IVUS) in detecting high-risk plaque features such as superficial erosion, protruding calcified nodules, and necrotic cores. It reviews emerging clinical evidence suggesting that prophylactic PCI of such plaques—before clinical symptoms arise—may reduce the risk of future adverse cardiac events.
By synthesizing current knowledge and addressing ongoing trials, the study underscores the potential for a paradigm shift in coronary artery disease management, from reactive to preventive strategies, aiming to improve long-term cardiovascular outcomes through early identification and stabilization of high-risk lesions.


DOWNLOAD PDF


The SCAI 2025 Guidelines for Chronic Venous Disease (CVD) provide a comprehensive, evidence-based framework for the diagnosis and management of CVD, a condition affecting over 25 million adults in the U.S. alone. Developed by the Society for Cardiovascular Angiography & Interventions (SCAI), the guidelines offer nine key consensus recommendations, emphasizing compression therapy, endovenous ablation, sclerotherapy, phlebectomy, and deep venous interventions such as venoplasty and stenting guided by intravascular ultrasound.
The guidelines also highlight four key knowledge gaps, including the role of phlebectomy in venous ulcers and the treatment of isolated femoral vein disease. While grounded in current evidence, the document acknowledges the limitations of available data and points toward future innovations such as microwave and mechanochemical ablation, AI-assisted monitoring, and 3D-printed stents.
These guidelines mark a critical step toward standardized, minimally invasive, and patient-centered management of CVD, bridging current practice with emerging technologies and highlighting areas in need of further clinical research.
.



DOWNLOAD PDF