Objective To observe the efficacy and safety of drug-coated balloon(DCB)in patients with ST-segment elevation myocardial infarction(STEMI)undergoing emergency percutaneous coronary intervention.To explore the predictive value of coronary CT angiography derived fractional flow reserve(CT-FFR)in postoperative follow-up of emergency DCB patients.Methods From June 2021 to June 2022,120 consecutive STEMI patients who received emergency coronary intervention and met the inclusion and exclusion criteria at Wuhan Asian Heart Hospital were collected.Patients were divided into the DCB group(60 patients)and the DES group(60 patients)according to a random number table.Baseline characteristics,operative data,major adverse cardiovascular events(MACE),and bleeding events during hospitalization and 9-month follow-up were collected,The baseline characteristics,radiographic outcomes,MACE and bleeding events during the 9-month follow period were compared between the two groups.CT-FFR was analyzed in DCB Group during the 9-month follow-up period.Results The incidence of coronary dissection in DCB group was significantly higher than that in DES group(16.7％vs.3.3％,P=0.015),after adequate preconditioning,most of the coronary dissections in DCB group were type B or less.The incidence of MACE,TIMI grade and serious bleeding events were similar between the two groups(P＞0.05).In DCB Group,32 patients were followed up during the 9-month period,CT-FFR of 27 patients was 0.80-0.96,none of them had MACE;and CT-FFR of 5 patients was 0.75-0.79,one case had an episode of angina pectoris,but the symptoms were relieved after adjusting medication.Conclusion Compared with DES,emergency DCB treatment in STEMI patients after adequate pretreatment is safe and effective,coronary angiography can be safely delayed in asymptomatic patients with CT-FFR≥0.75.
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