AUTHOR=Sun Kaiwen , Liu Zhenzhu , Wang Hongyan 

TITLE=Drug-Coated Balloon vs. Stent for de novo Non-small Coronary Artery Disease: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.700235

DOI=10.3389/fcvm.2021.700235

ISSN=2297-055X

ABSTRACT=<p><bold>Introduction:</bold> Drug-coated balloon (DCB) has been an attractive option in <italic>de novo</italic> vessels. A systematic review and meta-analysis were conducted to evaluate the efficacy and safety of DCB vs. stent for treating <italic>de novo</italic> lesions in non-small vessels.</p><p><bold>Methods:</bold> Studies in PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science were searched (from their commencement to March 2021). This meta-analysis was performed by Review Manager 5.3.</p><p><bold>Results:</bold> A total of 3 random controlled trials (RCTs) with 255 patients and 2 observational studies (OS) with 265 patients were included in this meta-analysis following our inclusion criteria. It could be observed that DCB presented no significant difference in cardiac death (CD) (<italic>RR</italic> 0.33, 95% CI [0.01, 8.29], <italic>p</italic> = 0.50 in OS), myocardial infarction (MI) (<italic>RR</italic> 0.49, 95% CI [0.09, 2.50], <italic>p</italic> = 0.39 in RCT), target lesion revascularization (TLR) (<italic>RR</italic> 0.64, 95% CI [0.19, 2.18], <italic>p</italic> = 0.47 in RCT) (<italic>RR</italic> 1.72, 95% CI [0.56, 5.26], <italic>p</italic> = 0.34 in OS), and late lumen loss (LLL) (SMD −0.48, 95% CI [−1.32, 0.36], <italic>p</italic> = 0.26 in RCT) for <italic>de novo</italic> non-small coronary artery disease (CAD) compared with stents, whereas minimal lumen diameter (MLD) including MLD1 (SMD −0.67, 95% CI [−0.92 −0.42], <italic>p</italic> &lt; 0.00001 in RCT) and MLD2 (SMD −0.36, 95% CI [−0.61 −0.11], <italic>p</italic> = 0.004 in RCT) was smaller in DCB group.</p><p><bold>Conclusion:</bold> This systematic review showed that DCB might provide a promising way on <italic>de novo</italic> non-small coronary artery disease compared with stents. However, more RCTs are still needed to further prove the benefits of the DCB strategy.</p><p><bold>Systematic Review Registration:</bold><ext-link ext-link-type="uri" xlink:href="https://www.crd.york.ac.uk/PROSPERO/#recordDetails" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/PROSPERO/#recordDetails</ext-link>.</p>