Key result
DCB-only strategy shows comparable medium-term MACE rates to DES in large-vessel ACS.
Why the study?
The use of drug coated balloons in de novo large epicardial vessel disease and acute coronary syndromes remains under scrutiny due to a paucity of comparative outcome data.
Does a drug coated balloon (DCB) only strategy result in comparable major adverse cardiovascular events (MACE) compared to a drug eluting stent (DES) only strategy in patients with acute coronary syndromes undergoing PCI in de novo large epicardial vessels?
Observational (n=494)
Does a drug coated balloon (DCB) only strategy result in comparable major adverse cardiovascular events (MACE) compared to a drug eluting stent (DES) only strategy in patients with acute coronary syndromes undergoing PCI in de novo large epicardial vessels?
In patients with acute coronary syndromes and de novo large epicardial vessel disease (>3mm), a drug-coated balloon-only PCI strategy demonstrated comparable medium-term MACE, mortality, and repeat revascularisation rates to a drug-eluting stent-only strategy.
DCB-only PCI was associated with comparable MACE in ACS large vessels; leaves open randomized confirmation before practice change.
Introduction Drug coated balloons (DCB) in de novo large vessel disease and in acute coronary syndromes (ACS) remain under scrutiny with a paucity of data. Purpose This study reports on outcomes of a DCB only strategy compared to a drug eluting stent (DES) only strategy in large epicardial coronary arteries in an ACS population. Methods Retrospective analysis of prospectively collected data on all ACS patients undergoing percutaneous coronary intervention (PCI) from January 2021 to June 2025. The primary outcome was medium to long term major adverse cardiovascular events (MACE). Results There were 247 patients in the DCB arm with treated large epicardial vessels >3mm) and they were matched with 247 patients treated with DES. The median age was 64 (58-74) in the DCB group and 64 (57-73) in the DES group. No significant difference in MACE at median 21-month follow-up between the DCB and DES groups (10.1% vs 11.7%, p=0.94, all-cause mortality (5.3% vs 8.1%, p=0.44) or repeat revascularisation (4.9% vs 4.5%, p=0.49) in the DCB group compared to the DES group. Conclusion The medium-term clinical outcome following the use of a DCB only strategy in large vessel in ACS patient population was comparable to a DES only strategy.
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Khan et al. (2026) conducted an observational in Acute coronary syndromes with de novo large epicardial coronary artery disease (>3mm) (n=494). Drug-coated balloon (DCB) only strategy vs. Drug-eluting stent (DES) only strategy was evaluated on Medium- to long-term major adverse cardiovascular events (MACE) (p=0.94). A drug-coated balloon only strategy resulted in comparable medium-term MACE rates to a drug-eluting stent only strategy in ACS patients with large vessel disease (10.1% vs 11.7%, p=0.94).
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