Title : Comparative meta-analysis: Drug-coated balloon versus drug-coated stent – A comprehensive evaluation of efficacy and safety in stentless percutaneous coronary intervention for coronary artery disease management
Abstract:
Background:
In the realm of cardiovascular interventions, the comparison between Drug-Coated Balloon (DCB) and Drug-Coated Stent (DES) revolves around optimizing outcomes in coronary and peripheral artery diseases. While DCBs offer drug delivery without a permanent scaffold, DES combines drug elution with stent support. This dynamic presents a nuanced choice, balancing efficacy, safety, and the specific anatomical considerations of each patient.
Methodology:
A systematic review and meta analysis was done by searching in Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess) (OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tools assessment for RCTs. In the analysis, we used RevMan Cochrane software.
Results:
The meta-analysis included eight randomized controlled trials (RCTs) and 1823 patients, revealing significant findings favoring both interventions. Drug-coated balloon (DCB) demonstrated superiority in minimal lumen diameter (MLD) immediately post-PCI (Z=5.40, P<0.00001), while drug-coated stent (DCS) exhibited favorable outcomes for diameter stenosis post-PCI (Z=3.20, P=0.001). Additionally, DCB showed advantages in major adverse cardiac events (Z=2.88, P=0.004) during the 6-24 months follow-up period. These results provide valuable insights for clinicians considering stentless percutaneous coronary intervention for coronary artery disease management.
Conclusion:
This study conducts a thorough examination of Drug-Coated Balloon (DCB) versus Drug-Coated Stent (DES) efficacy and safety in stentless percutaneous coronary intervention for managing coronary artery disease. The comparative analysis aims to elucidate the optimal choice between these interventions, offering insights into their respective benefits and potential complications, ultimately contributing to informed decision-making in coronary artery disease treatment
Audience Take Away:
- Clinicians can utilize the findings to make informed decisions when choosing between drug-coated balloon (DCB) and drug-coated stent (DES) for percutaneous coronary intervention (PCI) in managing coronary artery disease (CAD)
- Researchers can incorporate the insights gained from this comprehensive evaluation into their studies on cardiovascular interventions
- Clinicians can improve patient outcomes by selecting the most suitable intervention based on efficacy and safety profiles outlined in the study
- Researchers can advance their understanding of DCB and DES efficacy and safety, enhancing their ability to develop novel interventions and treatment strategies
- Faculty members involved in medical education and research can utilize this study to expand their teaching materials and further investigate the comparative effectiveness of different interventions in CAD management
- While not directly related to design, this research simplifies decision-making for clinicians by providing comprehensive insights into the efficacy and safety of DCB versus DES in PCI for CAD management
- While not applicable to design accuracy, this research offers new information to assist clinicians in selecting the most appropriate intervention for CAD management, thus potentially improving patient outcomes and treatment efficacy
List all other benefits:
- Enhances patient care by informing clinicians of the optimal choice between DCB and DES for PCI in CAD management.
- Contributes to evidence-based medicine by synthesizing data from multiple randomized controlled trials (RCTs) and providing a comprehensive evaluation.
- Facilitates shared decision-making between clinicians and patients by presenting clear comparisons of efficacy and safety outcomes.
- Strengthens the foundation for future research in cardiovascular interventions by identifying areas of improvement and further investigation.
