Clinical Impact of Drug-Coated Balloon–Based Percutaneous Coronary Intervention in Patients With Multivessel Coronary Artery Disease

Data on drug-coated balloon (DCB) treatment in the context of multivessel coronary artery disease (CAD) are limited. The purpose of this study was to investigate the impact of DCB-based treatment on percutaneous coronary intervention for multivessel CAD. A total of 254 patients with multivessel dise...

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Published in:JACC. Cardiovascular interventions 2023-02, Vol.16 (3), p.292-299
Main Authors: Shin, Eun-Seok, Jun, Eun Jung, Kim, Sunwon, Kim, Bitna, Kim, Tae-Hyun, Sohn, Chang-Bae, Her, Ae-Young, Park, Yongwhi, Cho, Jung Rae, Jeong, Young-Hoon, Choi, Byung Joo
Format: Article
Language:English
Subjects:
Coated Materials, Biocompatible
Coronary Angiography
coronary artery disease
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - etiology
Coronary Artery Disease - therapy
Coronary Restenosis - etiology
drug-coated balloon
drug-eluting stent(s)
Drug-Eluting Stents
Humans
multivessel
paclitaxel-coated balloon
percutaneous coronary intervention
Percutaneous Coronary Intervention - adverse effects
Retrospective Studies
Treatment Outcome
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Summary:Data on drug-coated balloon (DCB) treatment in the context of multivessel coronary artery disease (CAD) are limited. The purpose of this study was to investigate the impact of DCB-based treatment on percutaneous coronary intervention for multivessel CAD. A total of 254 patients with multivessel disease successfully treated with DCBs or in combination with drug-eluting stents (DES) were retrospectively enrolled (DCB-based group) and compared with 254 propensity-matched patients treated with second-generation DES from the PTRG-DES (Platelet Function and Genotype-Related Long-Term Prognosis in Drug-Eluting Stent-Treated Patients With Coronary Artery Disease) registry (n = 13,160) (DES-only group). Major adverse cardiovascular events (MACE) comprised cardiac death, myocardial infarction, stroke, stent thrombosis, target vessel revascularization, and major bleeding at 2 years. Baseline clinical characteristics were comparable between the groups. In the DCB-based group, 34.3% of patients were treated with DCBs only and 65.7% were treated with the DES hybrid approach. The number of stents and total stent length were significantly reduced by 65.4% and 63.7%, respectively, in the DCB-based group compared with the DES-only group. Moreover, the DCB-based group had a lower rate of MACE than the DES-only group (3.9% and 11.0%; P = 0.002) at 2-year follow-up. The DES-only group had a higher risk for cardiac death and major bleeding. The DCB-based treatment approach showed a significantly reduced stent burden for multivessel percutaneous coronary intervention and led to a lower rate of MACE than the DES-only treatment. This study shows that DCB-based treatment approach safely reduces stent burden in multivessel CAD, and improved long-term outcomes may be expected by reducing stent-related events. (Impact of Drug-Coated Balloon Treatment in De Novo Coronary Lesion; NCT04619277) [Display omitted]
ISSN:1936-8798
1876-7605
DOI:10.1016/j.jcin.2022.10.049