Drug-coated balloons versus drug-eluting stents in patients with small coronary artery disease: an updated meta-analysis

Drug-coated balloons versus drug-eluting stents in patients with small coronary artery disease: an updated meta-analysis

Abstract Background Drug-coated balloons (DCB) have promising results in the management of large coronary artery lesions (CAD), still their role in treating small CAD is not well established. We aimed to provide a comprehensive appraisal of the efficacy and safety of DCBs in patients with small CAD....

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Main Authors: Ahmed Abdelaziz, Hanaa Elsayed, Karim Atta, Muhammad Desouky, Mahmoud Gomaa, Hallas Kadhim, Ahmed Mechi, Mohamed Abdelaziz, Mahmoud Ezzat, Manar Alaa Mabrouk, Mohamed Hatem Ellabban, Emad Addin Zawaneh, Abdelrahman Hafez, Mohamed Yasser Elnaggar, Ahmed O. Sena, Ahmed Bahnasy, Emad Singer
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Cardiovascular Disorders
Subjects:
Drug-coated balloon
Drug-eluting stent
Small coronary artery disease
Meta-analysis
Online Access:https://doi.org/10.1186/s12872-024-04426-5
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Summary:Abstract Background Drug-coated balloons (DCB) have promising results in the management of large coronary artery lesions (CAD), still their role in treating small CAD is not well established. We aimed to provide a comprehensive appraisal of the efficacy and safety of DCBs in patients with small CAD. Methods We searched PubMed, Scopus, web of science, Ovid, and Cochrane Central from inception until 30 March, 2023. We included all relevant studies that compared DCB versus drug-eluting stents (DES) in small CAD patients undergoing PCI. We reported clinical outcomes as MACE, all-cause death, cardiac death, MI, TLR, TVR, and stent thrombosis, while angiographic outcomes were late lumen loss (LLL), mean lumen diameter (MLD), net luminal gain (NLG), and in-segment binary restenosis. Results Twenty studies comprising 18,469 patients were included in this meta-analysis. The incidence rate of MACE was 9.4% in the DCB group compared to 9.9% in the DES group, without a significant difference in the risk of MACE (OR = 0.97, 95% CI: 0.77 to 1.22, p = 0.78). Moreover, DCB significantly decreased MLD and NLG compared to DES, with the following values, respectively (MD= -0.19, 95% CI: -0.32 to -0.06, p < 0.001, and MD -0.21, 95% CI: -0.40 to -0.01, p = 0.04). On the other hand, DCB was associated with higher odds in the risk of in-segment binary restenosis (OR 1.66, 95% CI: 1.03 to 2.68, p = 0.04). Conclusion DCB is an alternative approach to DES in the management of small CAD and should be validated in daily clinical practice. Prospero registration CRD42023413068.
ISSN:1471-2261

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