Clinical outcomes of revascularisation with drug-coated balloons in South Asian patients with complex coronary artery disease: A single-centre retrospective study

Background Coronary artery disease (CAD) is prevalent in South Asia, with younger patients showing complex conditions. Drug-coated balloons (DCBs) that deliver antiproliferative drugs without permanent implants are effective in small vessels. However, data from South Asia are scarce. This study assessed procedural success and six-month outcomes of DCB angioplasty in a South Asian cohort. Methods This retrospective, single-centre study involved 98 patients who underwent percutaneous coronary intervention with DCB between January and December 2024. Baseline demographics, lesion characteristics, procedural outcomes, and six-month follow-up data were analysed. The primary endpoints were cardiac death, target vessel myocardial infarction (TVMI), and target lesion revascularisation (TLR). Secondary outcomes included symptomatic improvements assessed using New York Heart Association classification. Results The mean age of the patients was 58.8 ± 10.5 years, with 80.6% being male. De novo lesions and in-stent restenosis accounted for 77.6% and 22.4% cases, respectively. Procedural success was achieved in 94 (95.9%) patients; however, 92 patients (93.9%) could be followed for six months. Cardiac death occurred in 15.2%, while TLR was required in 4.2% cases; no cases of TVMI were observed. Symptomatic improvement was noted in 85.9% of patients. Bailout stenting was required in 6.1%. Paclitaxel-coated balloons showed better functional improvement than sirolimus-coated balloons (p < 0.001). Patients with diabetes demonstrated higher cardiac mortality than those without diabetes. Conclusions DCB angioplasty demonstrated high procedural success, low TLR rates, and significant symptomatic improvement in a South Asian cohort, indicating its potential advantages in patients with complex CAD or high bleeding risks.