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The Clinical and Angiographic Outcomes of Postdilation after Percutaneous Coronary Intervention in Patients with

Yan Li1, Xiying Liang1, Wenjiao Zhang1

  • 1The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China.

Journal of Interventional Cardiology
|May 3, 2021
PubMed

Insights

Postdilation after percutaneous coronary intervention may reduce major adverse cardiovascular events (MACE) in acute coronary syndrome patients but significantly increases all-cause death. Further research is needed to clarify its overall impact.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • The role of postdilation following percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients remains debated.
  • Understanding the clinical and angiographic implications of postdilation is crucial for optimizing ACS management.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the clinical and angiographic outcomes of postdilation after PCI in patients with ACS.
  • To synthesize evidence regarding major adverse cardiovascular events (MACE), mortality, and procedural success.

Main Methods:

  • A comprehensive literature search was performed across multiple databases (PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wangfang) up to August 30, 2020.
  • Included studies focused on ACS patients undergoing PCI with or without postdilation.
  • Primary outcomes included MACE, all-cause death, stent thrombosis, myocardial infarction, target vessel revascularization, and angiographic measures like no-reflow and slow-reflow.

Main Results:

  • The meta-analysis of 11 studies indicated a trend towards reduced MACE with postdilation (OR=0.67, P=0.05).
  • However, postdilation was associated with a significant increase in all-cause death (OR=1.49, P=0.03).
  • No significant differences were observed for stent thrombosis, myocardial infarction, target vessel revascularization, no-reflow, or slow-reflow.

Conclusions:

  • Postdilation in ACS patients shows a tendency to decrease MACE but significantly elevates all-cause death.
  • It does not appear to significantly impact stent thrombosis, myocardial infarction, target vessel revascularization, or coronary flow grades.
  • Further randomized controlled trials are necessary to definitively establish the role and safety of postdilation in ACS.
Abstract

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