Outcomes with drug-coated balloons in small-vessel coronary artery disease

Michael Megaly, Michael Rofael, Marwan Saad, Ahmed Rezq, Louis P. Kohl, Ankur Kalra, Mehdi Shishehbor, Peter Soukas, J. Dawn Abbott, Emmanouil S Brilakis

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Percutaneous coronary intervention (PCI) of small-vessel coronary artery disease (SVD) is associated with increased risk of restenosis. The use of drug-coated balloons (DCBs) in SVD has received limited study. Objectives: To assess the outcomes of DCB in the treatment of SVD compared with the standard of care. Methods: We performed a meta-analysis of all studies published between January 2000 and September 2018 reporting the outcomes of DCB versus other modalities in the treatment of de novo SVD. Results: Seven studies with 1,824 patients (1,938 lesions) were included (four randomized controlled trials and three observational studies). During a mean follow-up of 14.5 ± 10 months, DCBs were associated with a similar risk of target lesion revascularization (TLR) (OR: 0.99, 95% CI: 0.54, 1.84, P = 97) and major adverse cardiovascular events (MACE) (OR: 0.86, 95% CI: 0.51, 1.45, P = 0.57) compared with drug-eluting stents (DES). During a mean follow-up of 7 ± 1.5 months, DCBs were associated with a significantly lower risk of TLR (OR: 0.19, 95% CI 0.04–0.88, P = 0.03) and binary restenosis (OR: 0.17, 95% CI 0.08–0.37, P = <0.00001) compared with noncoated balloon angioplasty. Conclusion: The use of DCBs in SVD is associated with comparable outcomes when compared with DES and favorable outcomes when compared with balloon angioplasty.

Original languageEnglish (US)
JournalCatheterization and Cardiovascular Interventions
DOIs
StateAccepted/In press - Jan 1 2018

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Coronary Artery Disease
Pharmaceutical Preparations
Drug-Eluting Stents
Balloon Angioplasty
Percutaneous Coronary Intervention
Standard of Care
Observational Studies
Meta-Analysis
Randomized Controlled Trials
Therapeutics

Keywords

  • drug-coated balloons
  • drug-eluting balloons
  • small-vessel disease coronary disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Outcomes with drug-coated balloons in small-vessel coronary artery disease. / Megaly, Michael; Rofael, Michael; Saad, Marwan; Rezq, Ahmed; Kohl, Louis P.; Kalra, Ankur; Shishehbor, Mehdi; Soukas, Peter; Dawn Abbott, J.; Brilakis, Emmanouil S.

In: Catheterization and Cardiovascular Interventions, 01.01.2018.

Research output: Contribution to journalArticle

Megaly, Michael ; Rofael, Michael ; Saad, Marwan ; Rezq, Ahmed ; Kohl, Louis P. ; Kalra, Ankur ; Shishehbor, Mehdi ; Soukas, Peter ; Dawn Abbott, J. ; Brilakis, Emmanouil S. / Outcomes with drug-coated balloons in small-vessel coronary artery disease. In: Catheterization and Cardiovascular Interventions. 2018.
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abstract = "Background: Percutaneous coronary intervention (PCI) of small-vessel coronary artery disease (SVD) is associated with increased risk of restenosis. The use of drug-coated balloons (DCBs) in SVD has received limited study. Objectives: To assess the outcomes of DCB in the treatment of SVD compared with the standard of care. Methods: We performed a meta-analysis of all studies published between January 2000 and September 2018 reporting the outcomes of DCB versus other modalities in the treatment of de novo SVD. Results: Seven studies with 1,824 patients (1,938 lesions) were included (four randomized controlled trials and three observational studies). During a mean follow-up of 14.5 ± 10 months, DCBs were associated with a similar risk of target lesion revascularization (TLR) (OR: 0.99, 95{\%} CI: 0.54, 1.84, P = 97) and major adverse cardiovascular events (MACE) (OR: 0.86, 95{\%} CI: 0.51, 1.45, P = 0.57) compared with drug-eluting stents (DES). During a mean follow-up of 7 ± 1.5 months, DCBs were associated with a significantly lower risk of TLR (OR: 0.19, 95{\%} CI 0.04–0.88, P = 0.03) and binary restenosis (OR: 0.17, 95{\%} CI 0.08–0.37, P = <0.00001) compared with noncoated balloon angioplasty. Conclusion: The use of DCBs in SVD is associated with comparable outcomes when compared with DES and favorable outcomes when compared with balloon angioplasty.",
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AU - Megaly, Michael

AU - Rofael, Michael

AU - Saad, Marwan

AU - Rezq, Ahmed

AU - Kohl, Louis P.

AU - Kalra, Ankur

AU - Shishehbor, Mehdi

AU - Soukas, Peter

AU - Dawn Abbott, J.

AU - Brilakis, Emmanouil S

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N2 - Background: Percutaneous coronary intervention (PCI) of small-vessel coronary artery disease (SVD) is associated with increased risk of restenosis. The use of drug-coated balloons (DCBs) in SVD has received limited study. Objectives: To assess the outcomes of DCB in the treatment of SVD compared with the standard of care. Methods: We performed a meta-analysis of all studies published between January 2000 and September 2018 reporting the outcomes of DCB versus other modalities in the treatment of de novo SVD. Results: Seven studies with 1,824 patients (1,938 lesions) were included (four randomized controlled trials and three observational studies). During a mean follow-up of 14.5 ± 10 months, DCBs were associated with a similar risk of target lesion revascularization (TLR) (OR: 0.99, 95% CI: 0.54, 1.84, P = 97) and major adverse cardiovascular events (MACE) (OR: 0.86, 95% CI: 0.51, 1.45, P = 0.57) compared with drug-eluting stents (DES). During a mean follow-up of 7 ± 1.5 months, DCBs were associated with a significantly lower risk of TLR (OR: 0.19, 95% CI 0.04–0.88, P = 0.03) and binary restenosis (OR: 0.17, 95% CI 0.08–0.37, P = <0.00001) compared with noncoated balloon angioplasty. Conclusion: The use of DCBs in SVD is associated with comparable outcomes when compared with DES and favorable outcomes when compared with balloon angioplasty.

AB - Background: Percutaneous coronary intervention (PCI) of small-vessel coronary artery disease (SVD) is associated with increased risk of restenosis. The use of drug-coated balloons (DCBs) in SVD has received limited study. Objectives: To assess the outcomes of DCB in the treatment of SVD compared with the standard of care. Methods: We performed a meta-analysis of all studies published between January 2000 and September 2018 reporting the outcomes of DCB versus other modalities in the treatment of de novo SVD. Results: Seven studies with 1,824 patients (1,938 lesions) were included (four randomized controlled trials and three observational studies). During a mean follow-up of 14.5 ± 10 months, DCBs were associated with a similar risk of target lesion revascularization (TLR) (OR: 0.99, 95% CI: 0.54, 1.84, P = 97) and major adverse cardiovascular events (MACE) (OR: 0.86, 95% CI: 0.51, 1.45, P = 0.57) compared with drug-eluting stents (DES). During a mean follow-up of 7 ± 1.5 months, DCBs were associated with a significantly lower risk of TLR (OR: 0.19, 95% CI 0.04–0.88, P = 0.03) and binary restenosis (OR: 0.17, 95% CI 0.08–0.37, P = <0.00001) compared with noncoated balloon angioplasty. Conclusion: The use of DCBs in SVD is associated with comparable outcomes when compared with DES and favorable outcomes when compared with balloon angioplasty.

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KW - drug-eluting balloons

KW - small-vessel disease coronary disease

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