title: Changes in high-sensitivity troponin after drug-coated balloon angioplasty for drug-eluting stent restenosis.
abstract: OBJECTIVE
  The success of drug-coated balloon therapy might be compromised by intraprocedural particulate embolisation of matrix coating, which may cause downstream microvascular obstruction. We aimed to investigate whether drug-coated balloon therapy was associated with an increase in markers of myocardial necrosis compared with drug-eluting stents or plain balloon angioplasty.
  
  
  RESULTS
  In the ISAR-DESIRE-3 trial, patients with limus-eluting stent restenosis were randomised to treatment with a paclitaxel-coated balloon (PCB), paclitaxel-eluting stent (PES) or balloon angioplasty. We included enrolled patients who had pre- and post-intervention high-sensitivity troponin (hs-TnT) levels available. The delta (peak post-procedure minus baseline) troponin was compared between treatment arms. The association between delta troponin tertiles and three-year mortality was also evaluated. Three hundred and forty-three (343) patients were included, comprising patients treated with PCB (n=115), PES (n=112) and balloon angioplasty (n=116). Groups were well matched in terms of baseline characteristics. There was no difference in delta troponin in patients treated with PCB, PES and balloon angioplasty (36±65, 70±183, and 51±124 ng/L, respectively, p=0.16). Three-year mortality was 7.7%, 8.8% and 14.3% for the 1st, 2nd and 3rd tertiles of delta troponin, respectively, p=0.23.
  
  
  CONCLUSIONS
  In patients with drug-eluting stent restenosis, there was no difference in subclinical myocardial necrosis among patients treated with PCB, PES, and balloon angioplasty.
authors.affiliation: Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Roisin
authors.initials: R
authors.lastname: Colleran
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Harada
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kufner
authors.forename: Daniele
authors.initials: D
authors.lastname: Giacoppo
authors.forename: Michael
authors.initials: M
authors.lastname: Joner
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cassese
authors.forename: Tareq
authors.initials: T
authors.lastname: Ibrahim
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.forename: Robert A
authors.initials: RA
authors.lastname: Byrne
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D017023:Coronary Angiography / Q000379:methods; D023903:Coronary Restenosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents