What does this research mean for the field?

DCB-based PCI resulted in lower MACE rates at 2 years (7.5% vs. 12.2%) and reduced target vessel revascularization (1.8% vs. 4.2%) compared to DES-only PCI in octogenarians. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

This study aims to assess the effectiveness of drug-coated balloon treatment compared to drug-eluting stents in elderly patients with coronary artery disease.

February 8, 2026

Clinical outcomes of drug-coated balloon vs. drug-eluting stent in octogenarians with coronary artery disease: a propensity score-matched study

Key Result

DCB-based PCI in octogenarians reduced 2-year MACE to 7.5% versus 12.2% with DES-only PCI, and target vessel revascularization to 1.8% versus 4.2%.

Key Points

This study aims to assess the effectiveness of drug-coated balloon treatment compared to drug-eluting stents in elderly patients with coronary artery disease.
Retrospective analysis of 141 octogenarians undergoing PCI with DCB and 710 with drug-eluting stents.
Comparison of major adverse cardiovascular events at 2-year follow-up.
Analysis of stent usage, length, and patient outcomes.
DCB-based PCI group had significantly fewer stents and shorter stent lengths than DES-only group.
MACE rate was lower in the DCB group (7.5% vs. 12.2%, P = 0.021).
Reduction in target vessel revascularization noted (1.8% vs. 4.2%, P = 0.032).

Structured PICO

Does DCB-based PCI reduce major adverse cardiovascular events compared to DES-only PCI in octogenarians with coronary artery disease?

Population

851 octogenarians (aged >= 80 years) with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).

Intervention

Drug-coated balloon (DCB)-based PCI (DCB alone or in combination with drug-eluting stent after pre-dilation).

Comparator

Second-generation drug-eluting stent (DES) alone.

Outcome

Major adverse cardiovascular events (MACE) at 2-year follow-up.composite

In octogenarians with coronary artery disease, a DCB-based PCI strategy significantly reduced 2-year MACE and target vessel revascularization while minimizing stent burden compared to DES alone.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background Evidence on drug-coated balloon (DCB) treatment in very elderly patients remains scarce. Purpose This study evaluated the efficacy of DCB-based percutaneous coronary intervention (PCI) in octogenarians with coronary artery disease (CAD). Methods A retrospective analysis included 141 patients aged 80 or older who underwent PCI with either DCB alone or in combination with drug-eluting stent (DES) after pre-dilation (DCB-based PCI). Their outcomes were compared with those of 710 octogenarians who underwent PCI with second-generation DES alone (DES-only PCI). The primary endpoint was major adverse cardiovascular events (MACE) at 2-year follow-up. Results In the DCB-based PCI group, 66.9% received DCB-only treatment. Compared to DES-only PCI, the DCB-based PCI group had fewer stents (0.4 ± 0.6 vs. 1.8 ± 0.9, P 0.001), shorter stent lengths (10.8 ± 17.4 mm vs. 37.2 ± 20.8 mm, P 0.001), and a lower usage of small-diameter stents (≤ 2.5 mm) (8.5% vs. 39.7%, P 0.001). The MACE rate after 2-year follow-up was significantly lower in the DCB-based PCI group (7.5% vs. 12.2%, P = 0.021), with a notable reduction in target vessel revascularization (1.8% vs. 4.2%, P = 0.032). These findings remained robust across multiple statistical matching approaches. Conclusion DCB-based PCI minimized stent burden, particularly small-diameter stents, and was associated with lower risks of MACE and target vessel revascularization compared to DES-only PCI in octogenarian patients. These findings suggest that DCB-based PCI may be a beneficial alternative for very elderly patients.

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