Outcomes after Paclitaxel Coated Device Use in Patients with Peripheral Artery Disease: A Nationwide Population Based
Chen-Yu Huang1, Jen-Kuang Lee2, Hsu-Ping Wu3
1Cardiovascular Centre, Cathay General Hospital, Taipei, Taiwan.
Summary
Paclitaxel-coated devices (PCDs) in peripheral artery disease revascularization were associated with lower mortality and cardiovascular risks. Limb outcomes showed no significant difference, challenging prior meta-analysis findings.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Health Outcomes Research
Background:
- Previous meta-analyses suggested increased mortality with paclitaxel-coated devices (PCDs) for peripheral artery disease (PAD) revascularization beyond one year.
- These findings have been met with controversy, necessitating further real-world safety evaluations.
Purpose of the Study:
- To conduct a real-world safety analysis of PCDs in patients undergoing endovascular lower limb revascularization.
- To investigate the association between PCD use and mortality, limb outcomes, and cardiovascular outcomes.
Main Methods:
- A nationwide retrospective cohort study utilized administrative medical data from Taiwan's National Health Insurance Research Database.
- 19,612 patients undergoing endovascular lower limb revascularization between May 2016 and December 2019 were analyzed.
- Propensity score matching was employed to compare outcomes between patients receiving PCDs and non-PCDs.
Main Results:
- Over a median of 14.2 months, patients receiving PCDs had a lower risk of all-cause death (sHR 0.71) compared to non-PCDs.
- The composite cardiovascular outcome was less frequent in the PCD group (20.1%) versus the non-PCD group (23.3%) (sHR 0.79).
- No significant difference was observed in the composite limb outcome between the PCD and non-PCD groups (sHR 0.98).
Conclusions:
- Paclitaxel-coated devices (PCDs) in endovascular revascularization are associated with a reduced risk of all-cause death.
- PCD use was linked to a lower composite cardiovascular outcome risk.
- There was no discernible difference in composite limb outcomes between PCD and non-PCD groups.
Keywords:
All cause mortalityComposite cardiovascular outcomeComposite limb outcomePaclitaxel coated devicePeripheral artery diseasePeripheral endovascular interventionMore Related Videos
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