关键词: 药物涂层球囊, 冠心病, 经皮冠状动脉介入治疗, 老年患者

Abstract: Objective　This study aims to examine the efficacy of drug-coated balloon (DCB) treatment in elderly patients with in-situ lesions of the coronary arteries. Method　In the retrospective analysis, the Inner Mongolia Medical University Affiliated Hospital Elderly Medicine Center treated 128 elderly patients with coronary artery large vessel disease from January 2022 to December 2022, categorizing them into the DCB group, the drug-eluting stent (DES) group, and the bioresorbable vascular scaffold (BVS) group based on the surgical approach. Baseline data across groups were compared, with coronary angiography (CAG) performed preoperatively, immediately postoperatively, and during follow-up. The comparison encompassed preoperative target vessel reference diameter (RVD), as well as preoperative, immediately postoperative, and postoperative follow-up minimum lumen diameter (MLD), diameter stenosis (DS), acute gain (AG), residual diameter stenosis (RDS), and late lumen loss (LLL). Furthermore, the incidence of MACE events was compared among the groups. Results　The baseline data and coronary artery lesion characteristics did not exhibit statistically significant differences among the three groups before surgery (P>0.05). Immediately after surgery, MLD, RDS, and AG showed statistically significant differences (P<0.001). In pairwise comparisons, statistically significant differences were observed in MLD and RDS between the DCB group and DES/BVS groups (P<0.05), while significant differences were found in AG between the DCB group and DES/BVS groups (P<0.001), with no significant differences between the DES and BVS groups (P>0.05). Follow-up angiography post-surgery revealed no statistically significant differences in MLD and LLL among the three groups (P>0.05); however, RDS differences were statistically significant (P<0.05), with significant differences observed between the DCB and DES groups in Pairwise comparisons (P<0.05). The median follow-up for MACE events within 478 (425, 538) days showed no statistically significant differences in the occurrence rates of MACE events among the three groups (P all >0.05). Lasso-logistic regression analysis revealed that LDL-C levels and intervention history were independent risk factors for MACE events in all patients in this study (P<0.001).Conclusion　Drug-coated balloon (DCB) treatment proves to be a safe and effective therapeutic approach for coronary artery lesions in elderly patients. Elevated LDL-C levels and a history of intervention emerge as independent risk factors for major adverse cardiovascular events (MACE).

Key words: Drug-coated balloon, Coronary heart disease, Percutaneous coronary intervention, Elderly patients