System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Ahead of print

PubMed: 40549036 DOI: 10.1007/s00392-025-02700-w

Drug-coated balloon vs drug-eluting stent in de novo coronary lesions: a propensity score matched cohort study.

Clin Res Cardiol

Authors: Ulrike Baumer, Eva Steinacher, Andreas Hammer, Niema Kazem, Felix Hofer, Bernhard Frey, Irene Lang, Christian Hengstenberg, Rayyan Hemetsberger, Patrick Sulzgruber, Alexander Niessner, Lorenz Koller

Affiliations

  • Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
  • Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
  • Vienna Healthcare Group, 2nd Department of Medicine with Cardiology and Intensive Care Medicine, Clinic Landstrasse, Medical University of Vienna, Juchgasse 25, 1030, Vienna, Austria.

Abstract

BACKGROUND

The use of drug-coated balloons (DCB) in percutaneous coronary interventions (PCI) is increasing due to potential benefits mainly by avoiding foreign material although a widespread application area beyond in-stent restenosis lacks robust clinical data to date. As such, we aimed to assess the safety and efficacy of DCBs in treating de novo lesions.

METHODS

For this analysis, we included all patients treated with DCB in a de novo lesions from 2010 to 2019 at our institution. We performed a 1:1 propensity score matching to pair each DCB intervention with a comparable DES intervention. Follow-up continued until 09/2022 to assess clinical outcomes.

RESULTS

A total of 303 patients with de novo lesion were matched to 303 patients with comparable baseline characteristics. The median follow-up time was 5.7 years (IQR 2.7-9.3). There were no significant differences in cardiovascular (CV) mortality (HR 1.01 [95% CI 0.87-1.19], p value 0.874), all-cause mortality (HR 1.05 [95% CI 0.91-1.22], p value 0.491), MACE (HR 1.10 [95% CI 0.96-1.26], p value 0.170), acute myocardial infarction (HR 1.08 [95% CI 0.90-1.19], p value 0.308), or any revascularization (HR 1.03 [95% CI 0.90-1.19], p value 0.671) between both groups. However, we observed a trend toward lower rates of target lesion revascularization in patients with small vessel disease (HR 0.84 [95% CI 0.68-1.02], p value 0.072), and in side branch lesions (HR 0.79 [95% CI 0.58-1.04], p value 0.096).

CONCLUSION

DCBs demonstrated long-term safety and efficacy in de novo lesions, with promising trends in reducing target lesion revascularization in small vessel disease and side branches.

MeSH

Stents, Mortality, Heart Diseases, Safety, Drug-Eluting Stents, Pharmaceutical Preparations, Cohort Studies, Propensity Score, Wounds And Injuries