药物洗脱球囊与药物洗脱支架治疗冠状动脉疾病的比较：一项随机对照试验的荟萃分析

Comparison of drug-eluting balloon versus drug-eluting stent for treatment of coronary artery disease: a meta-analysis of randomized controlled trials.

作者信息

Liu Lulu, Liu Bin, Ren Jiajun, Hui Gang, Qi Chao, Wang Junnan

机构信息

Department of Cardiology, Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun, 130041, China.

出版信息

BMC Cardiovasc Disord. 2018 Mar 2;18(1):46. doi: 10.1186/s12872-018-0771-y.

BACKGROUND

Drug-eluting balloons (DEB) have significant value for treating coronary artery disease (CAD). However, the merits of using DEB versus drug-eluting stents (DES) to treat CAD remain controversial. Herein, we conducted a meta-analysis to compare the safety and efficacy of DEB and DES for treatment of CAD.

METHODS

We searched MEDLINE, EMBASE, and CENTRAL databases for eligible trials comparing DEB with DES for treatment of CAD. The primary endpoint was major adverse cardiac events (MACE); the secondary endpoints included in-lesion late lumen loss (LLL), binary restenosis (BR), myocardial infarction (MI), target lesion revascularization (TLR) and mortality.

RESULTS

Twenty-three trials with a total of 2712 patients were included. There were no significant differences in the primary endpoint of MACE between the DEB and DES groups (Risk Ratio (RR) 1.19; 95% confidence interval (CI) (0.87, 1.63); P = 0.27), or in the clinical outcomes of each of MACE's components, including TLR, MI and mortality. However, efficacy was significantly different between the DEB and DES groups, especially when we compared DEB to second-generation DES: in-lesion LLL (Mean Difference (MD) 0.11; (0.01, 0.22); P = 0.03); binary restenosis (RR 1.46; (1.00, 2.13); P = 0.05).

CONCLUSIONS

DEB is equivalent to DES in terms of safety for managing CAD, and DEB may be considered as an alternative choice for treatment of CAD.

背景

药物洗脱球囊（DEB）在治疗冠状动脉疾病（CAD）方面具有重要价值。然而，使用DEB与药物洗脱支架（DES）治疗CAD的优点仍存在争议。在此，我们进行了一项荟萃分析，以比较DEB和DES治疗CAD的安全性和有效性。

方法

我们检索了MEDLINE、EMBASE和CENTRAL数据库，以寻找比较DEB与DES治疗CAD的符合条件的试验。主要终点是主要不良心脏事件（MACE）；次要终点包括病变内晚期管腔丢失（LLL）、二元再狭窄（BR）、心肌梗死（MI）、靶病变血运重建（TLR）和死亡率。

结果

纳入了23项试验，共2712例患者。DEB组和DES组在MACE主要终点方面无显著差异（风险比（RR）1.19；95%置信区间（CI）（0.87，1.63）；P = 0.27），在MACE各组成部分的临床结局方面，包括TLR、MI和死亡率，也无显著差异。然而，DEB组和DES组在疗效上有显著差异，尤其是当我们将DEB与第二代DES进行比较时：病变内LLL（平均差（MD）0.11；（0.01，0.22）；P = 0.03）；二元再狭窄（RR 1.46；（1.00，2.13）；P = 0.05）。