Drug coated balloon versus drug eluting stent for treatment of small-vessel coronary artery disease: a meta-analysis of randomized controlled trials

Zayed, Yazan

Drug coated balloon versus drug eluting stent for treatment of small-vessel coronary artery disease: a meta-analysis of randomized controlled trials

Wednesday, May 22, 2019

Belmont Ballroom 2-3 (The Cosmopolitan of Las Vegas)

Yazan Zayed, M.D. , Hurley Medical Center\Michigan State University, Flint, MI

Mahmoud Barbarawi , Hurley Medical Center\Michigan State University, Flint, MI

Babikir Kheiri, MD , Hurley Medical Center\Michigan State University, Flint, MI

Sina Khaneki, MD , Hurley Medical Center\Michigan State University, Flint, MI

Saadia Shafi, MD , Hurley Medical Center\Michigan State University, Flint, MI

Saadia Bader, MD , Hurley Medical Center\Michigan State University, Flint, MI

Ghassan Bachuwa, MD, MS, MHSA , Hurley Medical Center\Michigan State University, Flint, MI

Mustafa Hassan, MD, MRCP, MMSc , Hurley Medical Center\Michigan State University, Flint, MI

Background:
Drug-coated balloons (DCBs) are considered a novel therapy for native small coronary artery disease. We aim to compare between DCBs and drug eluting stents (DES) in the management of small-vessel coronary artery disease (CAD)

Methods
An electronic database search was performed to identify all randomized controlled trials (RCTs) comparing DCB vs DES in the treatment of small vessel CAD. We used a random effects model to calculate risk ratios (RRs) with their corresponding 95% confidence intervals (CIs).

Results
We included 4 RCTs representing a total of 1,187 patients (mean age 66 +- 10.5 years and 74% male). Mean follow up duration ranged from 9 months to 2 years. In comparison to DES, the use of DCB for treatment of small-vessel CAD was not associated with significant reduction of major adverse cardiovascular events (MACE) (RR 1.01; 95% CI 0.55-1.85; P=0.98), all-cause mortality (RR 1.73; 95% CI 0.70-4.22; P=0.23), myocardial infarction (RR 0.52; 95% CI 0.25-1.08; P=0.08); target lesion revascularization (RR 1.34; 95% CI 0.46-3.95; P=0.59), target-vessel revascularization (RR 0.88; 95% CI 0.52-1.51; P=0.65), or in-segment binary stenosis (RR 1.28; 95% CI 0.59-2.78; P=0.54).

Conclusions
Among patients with small vessel CAD, there was no difference between DCB and DES in regard to MACE, all-cause death, myocardial infarction, target lesion revascularization, target vessel revascularization or in-segment binary restenosis. Large trials are needed to examine long-term outcomes and patients with maximum benefit with drug-coated balloons.