Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
October 22, 2026 · via Europe PMC
One-Year Clinical Outcomes of Paclitaxel-Coated Balloon Angioplasty in Patients With and Without Acute Coronary Syndrome: The ALLIANCE Registry.
Muramatsu T, Tanabe K, Kadota K, +15 more, Nakamura M
AI summary — for doctors, generated from the abstract only
In real-world DCB angioplasty, one-year target lesion failure and mortality were higher in ACS than non-ACS patients.
What was studied
Prospective Japanese registry of 1794 de novo lesion patients (513 ACS) treated with paclitaxel drug-coated balloons, with propensity matching.
Key findings
- Bailout stenting needed in only 1.1% of lesions.
- Intracoronary imaging was used in 88.5% of lesions.
- One-year TLF and all-cause mortality were significantly higher in ACS.
Clinical relevance
Shows DCB is feasible in ACS but carries higher event risk than in stable disease.
Who should care
Limitations
Non-randomized registry with no stent comparator and the abstract omits exact event rates.
DCB can be used in selected ACS lesions with good technique, but counsel higher event risk and follow closely.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
BACKGROUND
Real-world data after percutaneous coronary intervention (PCI) using drug-coated balloons (DCBs) in acute coronary syndrome (ACS) are limited.
AIMS
We compared 1-year clinical outcomes after PCI with paclitaxel DCBs between the ACS and non-ACS patients.
METHODS
The ALLIANCE is a prospective, multicenter registry of PCI using paclitaxel DCBs. Primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, myocardial infarction (MI), or clinically driven target lesion revascularization. Secondary endpoints included all-cause mortality at 1 year. Adverse events were adjudicated by an independent committee. Propensity score matching was performed to adjust for baseline differences between the ACS and non-ACS patients.
RESULTS
From July 2023 to February 2024, 1794 patients with de novo lesions (ACS 513 [28.6%] and non-ACS 1281 [71.4%]) were enrolled at 57 medical institutions in Japan. Mean age was 71 years, and 76% were male. Among ACS patients, 34.7% had ST-segment elevation MI, 33.9% non-ST-segment elevation MI, and 31.4% unstable angina. Intracoronary imaging was used in 88.5% of lesions. Bailout stenting after DCB angioplasty was required in only 1.1% of 1984 lesions. Technical success, defined as post-procedural residual stenosis < 40% and absence of flow-limiting coronary dissection, was significantly lower in patients with ACS than those with non-ACS. At 1 year, TLF occurred in 7.0% of ACS and 3.8% of non-ACS patients (adjusted HR 1.83; 95% CI 1.06-3.17, p = 0.03). All-cause mortality was 6.4% and 3.3%, respectively (adjusted HR 2.06; 95% CI 1.13-3.75, p = 0.02).
CONCLUSIONS
One-year TLF and all-cause mortality were significantly higher in ACS than non-ACS patients treated with paclitaxel DCBs in real-world clinical settings.
REGISTRATION
Japan Registry of Clinical Trials (https://jrct.mhlw.go.jp); unique identifier: jRCT1032230218.
DOI
10.1002/ccd.70952
PMID
42908363
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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