Long-Term Efficacy and Safety of Drug-Eluting Stent Versus Drug-Coated Balloon for De Novo Lesions in Small-Vessel Coronary Disease: A Systematic Review and Meta-Analysis

Razzack, Aminah Abdul; Pothuru, Suveenkrishna; Hassan, Syed Adeel; Mandava, Sri; Castellanos, D Missael Rocha; Reddy, Krishna Theja; Mendez, A Lopez; Arshad, Junaid; Sattar, Yasar

doi:10.1016/j.carrev.2021.06.051

Cited by 1 publication

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, 6 eligible studies were included in our metaanalysis. Therefore, the statistical power of this meta-analysis was significantly higher than the meta-analysis by Razzack et al (23), generating more reliable results. As a result, we can have the confidence to convince that DCB is associated with fewer MACE outcomes than DES in treating small-vessel coronary artery lesions in diabetic patients.…”

Section: Figurementioning

confidence: 57%

“…In addition, the meta-analysis by Elgendy et al ( 22 ) assessed the differences in reducing TLR between DCB and DES in novo small-vessel coronary artery by introducing subgroup analysis; however, this meta-analysis did not also isolate diabetic patients form general populations. Another meta-analysis by Razzack et al ( 23 ) included eight studies first to investigate the difference in therapeutic efficacy and safety between DCB and DES in treating de novo lesions in small-vessel coronary disease. Then, the authors evaluated the therapeutic value of DCB in diabetic patients by introducing a subgroup analysis involving 3 studies, indicating no statistical difference between DCB and DES regarding the MACE outcome [odds ratio (OR), 1.34; 95% CI, 0.73–2.46; p = 0.34], inconsistent with our finding.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, several studies (21)(22)(23)(24)(25) have investigated the comparative efficacy and safety of DCB vs. DES for treating de novo lesions in small-vessel coronary disease using the metaanalytic technique. However, the meta-analyses by Li et al (21) did not isolate diabetic patients from general populations, although authors found that DCB was non-inferior to DES, delivering a good outcome in non-fatal MI, and can be recommended as an optimal treatment strategy in patients with de novo small-vessel coronary artery diseases.…”

Section: Figurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Currently, several clinical trials and meta-analyses have evaluated the therapeutic role of DCB in treating small-vessel coronary artery lesions, indicating that the therapeutic efficacy and safety of DCB were not inferior to DES (21)(22)(23)(24)(25). However, only the meta-analysis by Razzack et al (23) attempted to evaluate the therapeutic value of DCB in diabetic patients by introducing a subgroup analysis. Notably, this subgroup analysis involved only 3 eligible studies, which provided limited data to investigate the difference between DCB and DES in the treatment of small vessel coronary artery disease in diabetic patients.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The comparative short-term efficacy and safety of drug-coated balloon vs. drug-eluting stent for treating small-vessel coronary artery lesions in diabetic patients

Cui

Dan

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

PurposeThis meta-analysis aimed to explore the comparative short-term efficacy and safety of drug-coated balloon (DCB) vs. drug-eluting stent (DES) for treating small-vessel coronary artery lesions in diabetic patients.MethodsWe searched PubMed, EMBASE, the Cochrane Library, and China National Knowledgement Infrastructure (CNKI) for retrieving relevant studies regarding the comparison of DCB with DES in treating small-vessel coronary artery lesions in diabetic patients until May 31, 2022. Two independent authors screened study, extracted data, and assessed methodological quality. Then, the meta-analysis was conducted using RevMan software, version 5.4.ResultsWe included 6 studies with 847 patients in this meta-analysis. Pooled results showed that DCB was associated with fewer major adverse cardiac events (MACE) [RR, 0.60; 95% confidence interval (CI), 0.39–0.93; p = 0.02], myocardial infarction (MI) (RR, 0.42; 95% CI, 0.19–0.94; p = 0.03), target lesion revascularization (TLR) (RR, 0.24; 95% CI, 0.08–0.69; p < 0.001), target vessel revascularization (TVR) (RR, 0.33; 95% CI, 0.18–0.63; p < 0.001), binary restenosis (RR, 0.27; 95% CI, 0.11–0.68; p = 0.005), and late lumen loss (LLL) [mean difference (MD), −0.31; 95% CI, −0.36 to −0.27; p < 0.001], but was comparable technique success rate, death, minimal lumen diameter (MLD), and net lumen gain (NLG) to DES. There was no difference in long-term outcomes between these two techniques.ConclusionsThis meta-analysis shows that DCB is better than DES in the short-term therapeutic efficacy and safety of small-vessel coronary artery lesions in diabetic patients. However, more studies are required to validate our findings and investigate the long-term effects and safety of DCB.

show abstract

Section: Figurementioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%