Key result
DCB is linked to similar TLR and lower thrombosis vs DES in de novo coronary lesions.
Why the study?
Does treatment with drug coated balloons reduce target lesion restenosis and thrombosis in de novo coronary artery lesions compared to new generation drug-eluting stents?
Cohort (n=7,655)
No
Does treatment with drug coated balloons reduce target lesion restenosis and thrombosis in de novo coronary artery lesions compared to new generation drug-eluting stents?
Hazard Ratio: 1.05 (95% CI 0.72–1.53)
Absolute Event Rate: 7% vs 4.9%
Drug coated balloons appear to be a safe and effective alternative to new generation drug-eluting stents for de novo coronary lesions, with similar restenosis rates and potentially lower thrombosis risk.
BACKGROUND: Studies comparing drug coated balloons (DCB) with new generation drug-eluting stents (nDES) for the treatment of de novo coronary artery lesions are lacking. METHODS: From 2009 to 2016, DCB or nDES used for treatment of de novo coronary lesions at our institution were included, in total 1,197 DEB and 6,458 nDES. We evaluated target lesions restenosis (TLR) and definite target lesion thrombosis (TLT). Propensity score modeling were utilized to study adjusted associations between treatment and outcomes. RESULTS: Median follow-up was 901days. DCB patients were older, with higher cardiovascular risk profile. Bailout stenting after DCB was performed in 8% of lesions. The cumulative rate of TLR and TLT was 7.0 vs. 4.9% and 0.2 vs. 0.8% for DCB vs. nDES, respectively. Before adjustment, DCB was associated with a higher risk of TLR [hazard ratio (HR) 1.44; 95% confidence interval (CI) 1.07-1.94] and a non-significantly lower risk of TLT (HR 0.30; 95% CI 0.07-1.24), compared to nDES. In the propensity matched population consisted of 1,197 DCB and 1,197 nDES, treatment with DCB was associated with similar risk for TLR (adjusted HR 1.05; 95% CI 0.72-1.53) but significantly lower risk for TLT (adjusted HR 0.18; 95% CI 0.04-0.82) compared to nDES. CONCLUSIONS: Treatment with DCB was associated with a similar risk of TLR and a lower risk of definite TLT compared with nDES. In selected cases, DCB appears as a good alternative to nDES for the treatment of de novo coronary lesions.
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Venetsanos et al. (2018) conducted a cohort in de novo coronary artery lesions (n=7,655). Drug coated balloons (DCB) vs. New generation drug-eluting stents (nDES) was evaluated on target lesions restenosis (TLR) (adjusted HR 1.05, 95% CI 0.72-1.53). Drug-coated balloons for de novo coronary lesions had a similar risk of target lesion restenosis (adjusted HR 1.05; 95% CI 0.72-1.53) and lower risk of thrombosis compared to drug-eluting stents.
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