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A Meta-Analysis of 3-Year Outcomes of Drug-Coated Balloons Versus Drug-Eluting Stents for Small-Vessel Coronary Artery Disease.
Dobromir Angheluta, Adelina; Levett, Jeremy Y; Zolotarova, Tetiana; Filion, Kristian B; Seirafi, Tara; Reynier, Pauline; Eisenberg, Mark J.
Afiliación
  • Dobromir Angheluta A; Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill University, Montreal, Quebec, Canada.
  • Levett JY; Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
  • Zolotarova T; Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
  • Filion KB; Division of Cardiac Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.
  • Seirafi T; Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill University, Montreal, Quebec, Canada.
  • Reynier P; Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill University, Montreal, Quebec, Canada.
  • Eisenberg MJ; Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
JACC Adv ; 3(10): 101204, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39252859
ABSTRACT

Background:

Drug-coated balloons (DCBs) may be a viable alternative to drug-eluting stents (DES) for de novo small caliber coronary artery lesions. However, there remains a lack of data regarding the long-term efficacy of this approach.

Objectives:

The purpose of this study was to compare the rates of major adverse cardiovascular events (MACE) after 3-year follow-up among patients randomized to DCB versus DES for the treatment of small caliber coronary arteries with reference vessel diameter between 2 and 3 mm.

Methods:

We systematically searched MEDLINE, EMBASE, and CENTRAL databases from their inception to July 2023 for randomized controlled trials comparing DCB versus DES for small caliber coronary artery disease. The primary end point was MACE at 3-year follow-up. Risk of bias was assessed using the Cochrane Risk of Bias Tool (RoB 2). Pooled risk ratios (RRs) and 95% CIs were estimated using random effects meta-analytic models.

Results:

Four randomized controlled trials (n = 1,402) were included. In total, 706 patients were randomized to DCB and 696 to DES. Participants were mostly male (74%), with a mean/median age ranging from 60 to 68 years. Pooled data across trials for MACE showed wide CIs, with little indication of DES superiority over DCB (RR 0.71; 95% CI 0.36-1.41). Most individual components of MACE were inconclusive. There was a potential signal for a reduction of target vessel thrombosis with DCB compared to DES (RR 0.25; 95% CI 0.06-1.08).

Conclusions:

Although sample sizes are small, 3-year outcomes suggest that DCB may be a reasonable alternative to DES for the treatment of small coronary arteries.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JACC Adv Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JACC Adv Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos