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Drug-eluting balloons similar to DES in CAD patients
Clinical efficacy and safety measures were similar between drug-eluting balloons and drug-eluting stents for the treatment of CAD in certain clinical settings in a recent meta-analysis published in the International Journal of Cardiology.
Study researchers included data on 1,462 patients from of eight studies that compared DEB with DES treatment in patients with CAD. The studies reported on at least one of these outcomes: late lumen loss (LLL), rates of overall mortality, MI, stent thrombosis and target lesion revascularization. All of the studies included in the meta-analysis (seven randomized and one cohort study) had at least 6-month follow-up periods with a median follow-up of 1 year. All studies were internally evaluated for quality.
Researchers found no clear benefits with the use of DES compared with the use of DEB in patients with obstructive CAD regarding mortality, MI, TLR and late stent thrombosis, although there was nonsignificant trend in DEB-treated patients for higher LLL (P=.18) and rate of binary restenosis (OR=1.40; P=.36).
In a prespecified meta-regression subgroup analysis, researchers found that LLL-weighted mean difference and TLR OR were directly correlated to reference coronary diameters. They were also inversely correlated to patients having diabetes.
“Another interesting finding of the prespecified subgroup analysis is the different performance of the Dior (Eurocor GmbH) DEB, with a higher LLL, which translated not only in higher binary restenosis rates, but also in more frequent TLR,” the researchers wrote. “Interestingly, the heterogeneity observed in this analysis was remarkably low, suggesting that a considerable portion of the heterogeneity observed in the main analysis could arise from differences in the DEB used. These findings parallel the recent report from the SCAAR registry, which found significant difference among different types of DEBs, suggesting that factors other than the drug itself may be important for the net clinical effect.”
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