Key result
While both drug-coated balloons and drug-eluting stents allow safe cessation of dual antiplatelet therapy after 1 month in patients with high bleeding risk, drug-coated balloons offer lower major adverse cardiovascular events.
Why the study?
Managing patients requiring PCI at high risk of bleeding remains challenging, requiring a balance between thrombotic and bleeding risks to determine the safest duration of DAPT.
Do drug-coated balloons reduce major adverse cardiovascular events compared to drug-eluting stents in patients at high bleeding risk requiring PCI?
Do drug-coated balloons reduce major adverse cardiovascular events compared to drug-eluting stents in patients at high bleeding risk requiring PCI?
In patients at high bleeding risk undergoing PCI, drug-coated balloons may offer lower MACE rates compared to drug-eluting stents when both are followed by 1 month of DAPT.
DCBs may enable shorter DAPT in high-bleeding-risk PCI; leaves open need for dedicated RCTs versus modern DES.
he management of patients who require percutaneous coronary intervention and are at high risk of bleeding continues to be challenging; balancing thrombotic risk versus bleeding risk to determine the safest duration of dual antiplatelet therapy (DAPT). With recent efforts to determine the safety of 1 month of DAPT after implantation of a drug-eluting stent, drug-coated balloons (DCBs) have also been explored, as both have been shown superior to bare-metal stents, which have historically been used for patients with high bleeding risk. We sought to review the literature surrounding the safety profile and bleeding events with both DCBs and drug-eluting stents, and conclude that while both offer safety of cessation of DAPT after 1 month, DCBs offer lower major adverse cardiovascular events.
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Corballis et al. (2020) conducted a review in High bleeding risk requiring percutaneous coronary intervention. Drug-coated balloons vs. Drug-eluting stents was evaluated on Major adverse cardiovascular events and bleeding events. While both drug-coated balloons and drug-eluting stents allow safe cessation of dual antiplatelet therapy after 1 month in patients with high bleeding risk, drug-coated balloons offer lower major adverse cardiovascular events.
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