Zeng Jinghan, Liu Yilu, Zhao Tianlang, Yuan Jiansong, Yang Weixian, Wang Man
Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China.
J Cardiovasc Dev Dis. 2025 Sep 17;12(9):359. doi: 10.3390/jcdd12090359.
We aimed to conduct a meta-analysis of treatments for large vessel coronary artery disease between drug-coated balloons and drug-eluting stents.
We searched databases including PubMed, Web of Science, Cochrane, CNKI, and Wanfang, and selected randomized controlled trials (RCTs) or cohort studies which compared drug-coated balloons (DCBs) with drug-eluting stents (DESs). The reference vessel diameter (RVD) should be greater than 2.75 mm. The results of 12 studies with a total of 2634 patients were included in this meta-analysis.
The results showed that the DCB group was not inferior to the DES group in terms of the incidence of target lesion revascularization (TLR). (RR = 1.25, 95% CI: [0.84, 1.85], = 0.27, I = 0%), and the incidence of bleeding events in the DCB group was lower than that in the DES group (RR = 0.30, 95% CI: [0.15, 0.59], = 0.0004). The results also showed that the post-intervention minimal lumen diameter (MLD) in the DCB group was smaller than that in the DES group. (RR = -0.37, 95% CI: [-0.59, -0.16], = 0.0007), but the follow-up MLD in the DCB group was not less than that in the DES group (RR = -0.03, 95% CI: [-0.14,-0.08], = 0.61). Additionally the DCB group had less late lumen loss (LLL) compared with the DES group. (RR = -0.31, 95% CI: [-0.60, -0.02], < 0.0001).
This meta-analysis confirms that in the early and late stages after percutaneous coronary intervention (PCI), DCB is not inferior in efficacy and safety to DES for de novo large coronary lesions with RVD > 2.75 mm.
我们旨在对药物涂层球囊与药物洗脱支架治疗大血管冠状动脉疾病进行荟萃分析。
我们检索了包括PubMed、Web of Science、Cochrane、中国知网和万方在内的数据库，并选择了比较药物涂层球囊（DCB）与药物洗脱支架（DES）的随机对照试验（RCT）或队列研究。参考血管直径（RVD）应大于2.75毫米。本荟萃分析纳入了12项研究，共2634例患者的结果。
结果显示，在靶病变血运重建（TLR）发生率方面，DCB组不劣于DES组。（风险比[RR]=1.25，95%置信区间[CI]：[0.84，1.85]，P=0.27，I²=0%），且DCB组出血事件发生率低于DES组（RR=0.30，95%CI：[0.15，0.59]，P=0.0004）。结果还显示，DCB组干预后最小管腔直径（MLD）小于DES组。（RR=-0.37，95%CI：[-0.59，-0.16]，P=0.0007），但DCB组随访时的MLD不少于DES组（RR=-0.03，95%CI：[-0.14，-0.08]，P=0.61）。此外，与DES组相比，DCB组的晚期管腔丢失（LLL）更少。（RR=-0.31，95%CI：[-0.60，-0.02]，P<0.0001）。
本荟萃分析证实，在经皮冠状动脉介入治疗（PCI）后的早期和晚期，对于RVD>2.75毫米的初发大冠状动脉病变，DCB在疗效和安全性方面不劣于DES。
