Drug eluting balloon versus drug eluting stent in percutaneous coronary interventions: Insights from a meta-analysis of 1462 patients

作者：Lupi Alessandro^*; Rognoni Andrea; Secco Gioel Gabrio; Porto Italo; Nardi Federico; Lazzero Maurizio; Rossi Lidia; Parisi Rosario; Fattori Rossella; Genoni Giulia; Rosso Roberta; Stella Pieter R; Sheiban Imad; Bolognese Leonardo; Liistro Francesco; Bongo Angelo Sante; Agostoni Pierfrancesco

来源：International Journal of Cardiology, 2013, 168(5): 4608-4616.

DOI：10.1016/j.ijcard.2013.07.161

• Drug-eluting stents
• Drug-eluting balloons
• Meta-analysis
• Angioplasty
• Stents
• Paclitaxel

Background: Drug eluting balloons (DEB) have been developed to overcome the limitations of drug eluting stents (DES), but clinic results of various DEB studies are still not consistent. Thus, we performed a meta-analysis to compare outcomes of DEB and DES for the treatment of coronary artery disease (CAD). %26lt;br%26gt;Methods: Medline/Web databases were searched for studies comparing DEB and DES for obstructive CAD, reporting late lumen loss (LLL) and rates for overall mortality, myocardial infarction (MI), stent thrombosis (ST) and target lesion revascularization (TLR). %26lt;br%26gt;Results: 8 studies (1462 patients) were included in themeta-analysis. Compared with DES, DEB treated patients showed non-significantly higher LLL (weighted mean difference [WMD] 0.32, 95% confidence interval [CI]-0.15 to 0.78, P = 0.18) and non-significantly higher rate of binary restenosis (odds ratio [OR] 1.40 [0.68-2.48], P = 0.36). Mortality (OR 1.13[0.54-2.37], P = 0.74), MI (OR 0.95, [0.50-1.80], P = 0.87), ST (OR 1.12, [0.34-4.19], P = 0.77) and TLR rates (OR 1.19[0.60-2.38], P = 0.61) were similar between the 2 treatments. A prespecified meta-regression analysis showed that LLL WMD and TLR OR were inversely correlated to the prevalence of diabetes (P %26lt; 0.0001) and directly correlated to reference coronary diameters (P %26lt; 0.001). %26lt;br%26gt;Conclusions: The present meta-analysis showed that compared to DES, DEB use resulted in similar clinical efficacy and safety. Thus DEB could be considered a reasonable alternative to DES for the treatment of CAD in selected clinical settings (Clinicaltrials. gov identifier: NCT01760200).

• 出版日期2013-10-12