Drug-Coated Balloons Versus Drug-Eluting Stents for Large Vessel Coronary Artery Disease: A Meta-Analysis.

Abstract

Objective: We aimed to conduct a meta-analysis of treatments for large vessel coronary artery disease between drug-coated balloons and drug-eluting stents.

Method: We searched databases including PubMed, Web of Science, Cochrane, CNKI, and Wanfang, and selected randomized controlled trials (RCTs) or cohort studies which compared drug-coated balloons (DCBs) with drug-eluting stents (DESs). The reference vessel diameter (RVD) should be greater than 2.75 mm. The results of 12 studies with a total of 2634 patients were included in this meta-analysis.

Results: The results showed that the DCB group was not inferior to the DES group in terms of the incidence of target lesion revascularization (TLR). (RR = 1.25, 95% CI: [0.84, 1.85], p = 0.27, I² = 0%), and the incidence of bleeding events in the DCB group was lower than that in the DES group (RR = 0.30, 95% CI: [0.15, 0.59], p = 0.0004). The results also showed that the post-intervention minimal lumen diameter (MLD) in the DCB group was smaller than that in the DES group. (RR = -0.37, 95% CI: [-0.59, -0.16], p = 0.0007), but the follow-up MLD in the DCB group was not less than that in the DES group (RR = -0.03, 95% CI: [-0.14,-0.08], p = 0.61). Additionally the DCB group had less late lumen loss (LLL) compared with the DES group. (RR = -0.31, 95% CI: [-0.60, -0.02], p < 0.0001).

Conclusion: This meta-analysis confirms that in the early and late stages after percutaneous coronary intervention (PCI), DCB is not inferior in efficacy and safety to DES for de novo large coronary lesions with RVD > 2.75 mm.