TY - JOUR
T1 - Outcomes with Drug-Coated Balloons in Percutaneous Coronary Intervention in Diabetic Patients
AU - Megaly, Michael
AU - Ali, Abdelrahman
AU - Abraham, Bishoy
AU - Khalil, Charl
AU - Zordok, Magdi
AU - Shaker, Marco
AU - Tawadros, Mariam
AU - Hennawy, Bassam S.
AU - Elbadawi, Ayman
AU - Omer, Mohamed
AU - Saad, Marwan
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/1
Y1 - 2020/1
N2 - Background: Percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM) remains associated with inferior clinical outcomes and an increased risk of restenosis compared with non-diabetics even in the era of drug-eluting stents (DES). The outcomes with drug-coated balloons (DCBs) in diabetic patients have received limited study. Methods: We performed a meta-analysis of all studies published between January 2000 and January 2019 reporting the outcomes with DCB vs. DES after PCI of de-novo coronary lesions in diabetic patients. Outcomes included major adverse cardiovascular events (MACE), target lesion revascularization (TLR), binary restenosis by quantitative coronary angiography (QCA), and late lumen loss (LLL). Results: Three studies with 378 patients (440 lesions) were included in the meta-analysis. During 17.3 ± 11.3 months follow-up, DCB were associated with a similar risk of MACE (OR: 0.63, 95% CI [0.36, 1.12], p = 0.11), TLR (OR: 0.51, 95% CI [0.25, 1.06] p = 0.07), binary restenosis (OR: 0.42, 95% CI [0.09, 1.92], p = 0.26), and LLL (mean difference: −0.13 mm, 95% CI [−0.41, 0.14], p = 0.34) compared with DES. Conclusion: In diabetic patients with de-novo coronary lesions undergoing PCI, DCBs are associated with similar outcomes compared with first-generation DES, with a signal toward potential benefit in lowering target lesion revascularization. Further randomized studies are needed to compare the newer-generation DCBs and DES in this setting.
AB - Background: Percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM) remains associated with inferior clinical outcomes and an increased risk of restenosis compared with non-diabetics even in the era of drug-eluting stents (DES). The outcomes with drug-coated balloons (DCBs) in diabetic patients have received limited study. Methods: We performed a meta-analysis of all studies published between January 2000 and January 2019 reporting the outcomes with DCB vs. DES after PCI of de-novo coronary lesions in diabetic patients. Outcomes included major adverse cardiovascular events (MACE), target lesion revascularization (TLR), binary restenosis by quantitative coronary angiography (QCA), and late lumen loss (LLL). Results: Three studies with 378 patients (440 lesions) were included in the meta-analysis. During 17.3 ± 11.3 months follow-up, DCB were associated with a similar risk of MACE (OR: 0.63, 95% CI [0.36, 1.12], p = 0.11), TLR (OR: 0.51, 95% CI [0.25, 1.06] p = 0.07), binary restenosis (OR: 0.42, 95% CI [0.09, 1.92], p = 0.26), and LLL (mean difference: −0.13 mm, 95% CI [−0.41, 0.14], p = 0.34) compared with DES. Conclusion: In diabetic patients with de-novo coronary lesions undergoing PCI, DCBs are associated with similar outcomes compared with first-generation DES, with a signal toward potential benefit in lowering target lesion revascularization. Further randomized studies are needed to compare the newer-generation DCBs and DES in this setting.
KW - Diabetes mellitus
KW - Drug-coated balloons
KW - Drug-eluting balloons
KW - Percutaneous coronary intervention
UR - https://www.scopus.com/pages/publications/85063763384
UR - https://www.scopus.com/pages/publications/85063763384#tab=citedBy
U2 - 10.1016/j.carrev.2019.03.001
DO - 10.1016/j.carrev.2019.03.001
M3 - Article
C2 - 30956042
AN - SCOPUS:85063763384
SN - 1553-8389
VL - 21
SP - 78
EP - 85
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
IS - 1
ER -