Drug-Coated Balloon versus Drug-Eluting Stent in Patients with Small-Vessel Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials

Background. Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) of small-vessel coronary artery disease (SVD) is related to an increased risk of in-stent restenosis (ISR) and stent thrombosis (ST). The application of the drug-coated balloon (DCB) for patients with SVD remains con...

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Main Authors: Xinying Wu, Lun Li, Li He
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2021/1647635
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author Xinying Wu
Lun Li
Li He
author_facet Xinying Wu
Lun Li
Li He
author_sort Xinying Wu
collection DOAJ
description Background. Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) of small-vessel coronary artery disease (SVD) is related to an increased risk of in-stent restenosis (ISR) and stent thrombosis (ST). The application of the drug-coated balloon (DCB) for patients with SVD remains controversial. Objectives. Assess the outcomes of DCB in the treatment of SVD compared with DES in patients with SVD. Methods. A meta-analysis of randomized controlled trials (RCTs) published up to June 2020, reporting the outcomes of DCB versus DES in the treatment of SVD, was performed. Results. Four RCTs with 1227 patients were included. The results indicated that DCB was associated with the decreased risk for myocardial infarction (MI) compared with the DES, but the difference showed no significance (OR 0.50, 95% CI 0.24–1.03, P=0.06). And, there was no significant difference in death (OR 0.76, 95% CI 0.17–3.43, P=0.72), cardiac death (OR 1.92, 95% CI 0.74–4.98, P=0.18), target vessel revascularization (TVR) (OR 0.81, 95% CI 0.51–1.28, P=0.36), target lesion revascularization (TLR) (OR 1.29, 95% CI 0.66–2.52, P=0.46), and major adverse cardiac events (MACE) (OR 0.92, 95% CI 0.61–1.38, P=0.69) between the DCB group and DES group. Conclusion. Compared with DES, DCB was associated with a decreased risk of MI among patients with SVD, but the difference showed no significance. The application of DCB in SVD is associated with comparable outcomes of death, TVR, and MACE when compared with DES.
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spelling doaj-art-9965c38aaa324aa1b9708edeb7e96f6e2025-08-20T03:37:03ZengWileyCardiology Research and Practice2090-80162090-05972021-01-01202110.1155/2021/16476351647635Drug-Coated Balloon versus Drug-Eluting Stent in Patients with Small-Vessel Coronary Artery Disease: A Meta-Analysis of Randomized Controlled TrialsXinying Wu0Lun Li1Li He2Department of Cardiology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Han Zheng Street 473, Wuhan 430033, ChinaDepartment of Cardiology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Han Zheng Street 473, Wuhan 430033, ChinaDepartment of Cardiology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Han Zheng Street 473, Wuhan 430033, ChinaBackground. Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) of small-vessel coronary artery disease (SVD) is related to an increased risk of in-stent restenosis (ISR) and stent thrombosis (ST). The application of the drug-coated balloon (DCB) for patients with SVD remains controversial. Objectives. Assess the outcomes of DCB in the treatment of SVD compared with DES in patients with SVD. Methods. A meta-analysis of randomized controlled trials (RCTs) published up to June 2020, reporting the outcomes of DCB versus DES in the treatment of SVD, was performed. Results. Four RCTs with 1227 patients were included. The results indicated that DCB was associated with the decreased risk for myocardial infarction (MI) compared with the DES, but the difference showed no significance (OR 0.50, 95% CI 0.24–1.03, P=0.06). And, there was no significant difference in death (OR 0.76, 95% CI 0.17–3.43, P=0.72), cardiac death (OR 1.92, 95% CI 0.74–4.98, P=0.18), target vessel revascularization (TVR) (OR 0.81, 95% CI 0.51–1.28, P=0.36), target lesion revascularization (TLR) (OR 1.29, 95% CI 0.66–2.52, P=0.46), and major adverse cardiac events (MACE) (OR 0.92, 95% CI 0.61–1.38, P=0.69) between the DCB group and DES group. Conclusion. Compared with DES, DCB was associated with a decreased risk of MI among patients with SVD, but the difference showed no significance. The application of DCB in SVD is associated with comparable outcomes of death, TVR, and MACE when compared with DES.http://dx.doi.org/10.1155/2021/1647635
spellingShingle Xinying Wu
Lun Li
Li He
Drug-Coated Balloon versus Drug-Eluting Stent in Patients with Small-Vessel Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials
Cardiology Research and Practice
title Drug-Coated Balloon versus Drug-Eluting Stent in Patients with Small-Vessel Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials
title_full Drug-Coated Balloon versus Drug-Eluting Stent in Patients with Small-Vessel Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials
title_fullStr Drug-Coated Balloon versus Drug-Eluting Stent in Patients with Small-Vessel Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials
title_full_unstemmed Drug-Coated Balloon versus Drug-Eluting Stent in Patients with Small-Vessel Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials
title_short Drug-Coated Balloon versus Drug-Eluting Stent in Patients with Small-Vessel Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials
title_sort drug coated balloon versus drug eluting stent in patients with small vessel coronary artery disease a meta analysis of randomized controlled trials
url http://dx.doi.org/10.1155/2021/1647635
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AT lunli drugcoatedballoonversusdrugelutingstentinpatientswithsmallvesselcoronaryarterydiseaseametaanalysisofrandomizedcontrolledtrials
AT lihe drugcoatedballoonversusdrugelutingstentinpatientswithsmallvesselcoronaryarterydiseaseametaanalysisofrandomizedcontrolledtrials