Cardiovascular Outcomes after Paclitaxel-Coated Balloon Angioplasty versus Drug-Eluting Stent Placement for Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Figures

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  Figure 4. Forest plots for comparisons of (A) target vessel revascularization (TVR), (B) target lesion revascularization (TLR), and (C) late luminal loss (LLL) between paclitaxel-coated balloon (PCB) angioplasty and drug-eluting stent (DES) placement in patients with acute coronary syndrome. The explanations of Forest plots were same with Figure 2. In (C), the values of N (number of cohort), Mean (mean magnitude of LLL), and SD (standard deviation) of the PCB and DES groups of 7 studies, and mean differences (MD) with 95%CI of 7 studies were shown. The values of mean LLL and SD referred from Table 4 and modified as mentioned in the text.

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  Figure 1. Flow chart of the systematic review. Among the 2025 studies, 9 studies were included. CCS: chronic coronary syndrome, BMS: bare-metal stent, DES: drug-eluting stent, PCB: paclitaxel-coated balloon.

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  Figure 2. Forest plots of (A) all of 9 studies, of (B) 8 studies excluding Study No. 9, and of (C) 5 RCTs, and (D) Galbraith plot of all of 9 studies for comparison of major adverse cardiac events (MACE) between paclitaxel-coated balloon (PCB) angioplasty and drug-eluting stent (DES) placement in patients with acute coronary syndrome. Definitions of MACE of 9 studies were summarized in Table 1. In the Forest plots, the black circles represent the point estimate, and the size of the circle is proportional to the weight given to each study in the meta-analysis. Horizontal solid black lines represent 95% confidence intervals (CI). The bottom diamond represents the summary estimate (size of the diamond = 95%CI). As the sensitivity analyses of the main estimate of the present study (A), two Forest plots, defining in the text, were shown. In Galbraith plot (D), regression line (solid line) with the area of 95%CI (grey zone) was shown. The black circles represent the studies, and the numbers corresponded to the included study number. All of the studies (1–9) were within the range of 95%CI.

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  Figure 3. Forest plots for comparisons of (A) cardiac mortality (CM), (B) all-cause mortality (ACM), (C) myocardial infarction (MI), and (D) major bleeding events (BLD) between paclitaxel-coated balloon (PCB) angioplasty and drug-eluting stent (DES) placement in patients with acute coronary syndrome. The explanation about the Forest plots was the same with Figure 2.

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  Figure 5. Forest plots for comparisons of (A) MACE, (B) cardiac mortality (CM), (C) all-cause mortality (ACM), and (D) target lesion revascularization (TLR) between paclitaxel-coated balloon (PCB) angioplasty and drug-eluting stent (DES) placement in patients with ST-elevated myocardial infarction (STEMI). As the sub-analysis, impacts of PCB angioplasty on the 4 cardiovascular outcomes in patients with STEMI were compared with those of DES placement. The explanations of Forest plots were same with Figure 2.