CC Cardiol Croat Cardiologia Croatica Cardiol. Croat. 1848-543X 1848-5448 Croatian Cardiac Society CC 2022 18_3-4_70-1 10.15836/ccar2023.70 Extended Abstract Incidence of restenosis after drug-coated balloon percutaneous coronary intervention in patients with chronic kidney disease – a single-centre experience https://orcid.org/0000-0003-2308-3518HanžekAntonio1* https://orcid.org/0000-0003-1762-9270OstojićZvonimir12 https://orcid.org/0000-0002-7865-1108LončarićFilip1 https://orcid.org/0000-0003-0497-6871PerčinLuka1 https://orcid.org/0000-0003-4689-1673KrčmarTomislav12 https://orcid.org/0000-0002-4004-7271Marić-BešićKristina12 https://orcid.org/0000-0002-9132-1568RadićDavor1 https://orcid.org/0000-0002-3197-2190PašalićMarijan1 https://orcid.org/0000-0003-3490-5505DošenDenis1 https://orcid.org/0000-0002-2599-553XJurinHrvoje1 https://orcid.org/0000-0001-5979-2346SkorićBoško12 https://orcid.org/0000-0001-9224-363XMargetićEduard12 https://orcid.org/0000-0001-9101-1570MiličićDavor12 https://orcid.org/0000-0002-1482-6503BulumJoško12 University Hospital Centre Zagreb, Zagreb, Croatia University of Zagreb School of Medicine, Zagreb, Croatia ADDRESS FOR CORRESPONDENCE: Antonio Hanžek, KBC Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia. / Phone: +385-98-9426-056 / E-mail: antoniohanzek0@gmail.com 032023 18 3-4 70 71 19022023 22022023 2023 Croatian Cardiac Society KEYWORDS: chronic coronary diseasedrug-coated balloonsPCIrestenosischronic kidney disease

Introduction: The efficiency of drug-coated balloon (DCB) percutaneous coronary intervention (PCI) has been shown for in-stent restenosis (ISR) and native small-vessel disease, with available data showing similar outcomes in both chronic kidney disease (CKD) and non-CKD patients (1). The aim is to compare the incidence of target lesion restenosis at follow-up (FUP) coronary angiography in patients with and without CKD receiving DCB PCI.

Patients and Methods: The registry included patients undergoing a DCB PCI at the University Hospital Centre Zagreb from February 2011 to January 2023 (n=652). Patient demographics, comorbidities, pharmacotherapy, as well as data on the initial and FUP coronary angiography/PCI was collected. Chronic kidney disease was defined as estimated glomerular filtration rate < 45 ml/min/1.73m2. A FUP angiography was performed in 49% of patients (n=317), with a median FUP of 6 (interquartile range 3 - 18) months, without difference between groups.

Results: Data is shown in Table 1. The cohort was 75% male, mean age 65 ± 10 years. CKD was present in 9% (n=57) of patients and was associated with a higher incidence of arterial hypertension, diabetes mellitus, atrial fibrillation, as well as peripheral artery disease. The age difference was noted between groups, with CKD patients being older on average. At initial PCI, more CKD patients had multivessel coronary disease, with a higher rate of ISR as the indication for DCB, that was not statistically significant (CKD vs non-CKD: 46% vs 34%, p=0.075). After DCB, no difference was noted between groups in regards to the need for a bail-out PCI (9% VS 6%, P=0.375). FUP was performed in an equal percentage of patients in both groups (48% vs 51%, p=0.769), with no differences seen in the incidence of restenosis (17% vs. 18%, p=0.998), the need for target lesion PCI (17% vs. 13%, p=0.533), or the use of anti-anginal drugs.

Comparison between chronic kidney disease (CKD) and non-CKD patients.
Patients with chronic kidney disease(n=57) Patients withoutchronic kidney disease(n=585) P -value
Initial PCI hospitalization
Age, years (mean ± SD) 72 ± 9 64 ± 10 <0.001*
Male sex, n (%) 38 (67) 445 (76) 0.147
History of myocardial infarction, n (%) 31 (54) 246 (42) 0.073
History of PCI, n (%) 39 (68) 347 (59) 0.180
History of CABG, n (%) 5 (9) 21 (4) 0.071
History of stroke or TIA, n (%) 7 (12) 34 (6) 0.057
History of atrial fibrillation, n (%) 19 (33) 61 (10) <0.001*
History of peripheral artery disease, n (%) 11 (19) 44 (8) <0.002*
Arterial hypertension, n (%) 55 (97) 502 (86) 0.022*
Diabetes mellitus, n (%) 32 (56) 190 (33) <0.001*
ACS as indication for DCB PCI, n (%) 25 (44) 275 (47) 0.679
Multivessel coronary disease, n (%) 39 (70) 292 (50) 0.013*
In-stent restenosis, n (%) 25 (46) 194 (34) 0.075
Bail-out PCI, n (%) 5 (9) 35 (6) 0.375
Follow-up hospitalization
Elective procedure, n (%) 18 (75) 244 (84) 0.261
Restenosis of target DCB PCI lesion, n (%) FUP cohort (n= 317) 4 (17) 51 (18) 0.998
Whole cohort (n=645) 4 (7) 51 (9) 0.808
SD – standard deviation, PCI – percutaneous coronary intervention, CABG – coronary artery bypass graft, TIA – transient ischemic attack, ACS – acute coronary syndrome, DCB – drug-coated balloon*p<0.05

Conclusion: The findings of our single-centre analysis show that patients with CKD do not have a higher risk of target lesion restenosis after DCB PCI, when compared to the non-CKD group, which is in accordance with currently available evidence (2).

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