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Paclitaxel-coated versus sirolimus-coated balloon angioplasty for coronary artery disease: A systematic review and meta-analysis

Lookup NU author(s): Professor Azfar ZamanORCiD

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Abstract

© 2024 Wiley Periodicals LLC. Background: Although use of sirolimus-based analogs has shown superiority over paclitaxel in drug-eluting stents, the relative efficacy of these two agents released from drug-coated balloons (DCB) is unclear. The present meta-analysis is aimed to compare outcomes after percutaneous coronary intervention (PCI) with paclitaxel-coated balloons (PCB) versus sirolimus-coated balloons (SCB) for either in-stent restenosis or native de novo lesions. Methods: The study outcomes were 1) target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction, or target lesion revascularization, and 2) follow-up angiographic parameters including late lumen loss (LLL), diameter stenosis, and minimal lumen diameter (MLD). Pooled odds ratios (OR) and weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated by using random-effects models. Results: A search of PubMed, EMBASE, and Cochrane Library from their inception to January 2024 identified five randomized clinical trials and three observational studies with a total of 1861 patients (889 in PCB and 972 in SCB groups). During 9–12 months of follow-up, there was no significant difference in TLF (OR 1.01, 95% CI 0.75–1.35) between the two groups. On follow-up angiography at 6–9 months, MLD (WMD 0.10, 95% CI 0.02–0.17) was larger in PCB but there was no statistically significant difference in LLL (WMD −0.11, 95% CI −0.23–0.02) and diameter stenosis (WMD −3.33, 95% CI −8.11–1.45). Conclusions: Among patients undergoing DCB-only PCI, the risk of TLF was similar during 9–12 months of follow-up after PCB and SCB treatment. However, the MLD was larger favoring PCB over SCB on follow-up angiography.

Publication metadata

Author(s): Shin D, Singh M, Shlofmitz E, Scheller B, Latib A, Kandzari DE, Zaman A, Mylotte D, Dakroub A, Malik S, Sakai K, Jeremias A, Moses JW, Shlofmitz RA, Stone GW, Ali ZA

Publication type: Article

Publication status: Published

Journal: Catheterization and Cardiovascular Interventions

Year: 2024

Volume: 104

Issue: 3

Pages: 425-436

Print publication date: 01/09/2024

Online publication date: 24/07/2024

Acceptance date: 12/07/2024

ISSN (print): 1522-1946

ISSN (electronic): 1522-726X

Publisher: John Wiley and Sons Inc.

URL: https://doi.org/10.1002/ccd.31154

DOI: 10.1002/ccd.31154

PubMed id: 39044661

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