Comparative Outcomes of Drug‐Eluting Balloons Versus Drug‐Eluting Stents in Patients With Diabetes Undergoing PPCI

Background The comparative outcomes of DEB vs. DES in diabetic patients undergoing PPCI are of significant clinical interest, as these patients often experience higher rates of restenosis and adverse outcomes. Aims This study aimed to compare the outcomes of drug‐eluting balloons (DEB) versus drug‐eluting stents (DES) in diabetic patients undergoing primary percutaneous coronary intervention (PPCI). Methods We conducted a retrospective analysis of 5668 diabetic patients who underwent PPCI, with 1734 patients in the DEB group and 3934 patients in the DES group. Baseline characteristics, angiographic features, and clinical outcomes, including procedural success, major adverse cardiovascular events (MACE), target lesion revascularization (TLR), restenosis, and bleeding complications, were compared between the two groups. Results Both DEB and DES groups demonstrated high procedural success rates (97.6% and 98.4%, respectively), with no significant differences in MACE, death, myocardial infarction, or target vessel revascularization. Restenosis at 6 months occurred in 3.9% of the DEB group and 3.4% of the DES group ( p = 0.21). Lesion length, diabetes duration, hypertension, and prior myocardial infarction were identified as significant predictors of adverse outcomes. Use of DES was associated with a higher risk of MACE, but this did not translate into significant differences in clinical outcomes. Conclusion Both DEB and DES are effective and safe treatment options for diabetic patients undergoing PPCI, with comparable outcomes in terms of procedural success, MACE, and restenosis.