Comparing long-term outcomes of drug-coated balloons and drug-eluting stents for the treatment of coronary artery disease

This study compared the long-term safety and effectiveness of drug-coated balloons (DCB) and drug-eluting stents (DES) for the treatment of coronary artery disease (CAD). This study showed that DCB is as safe and effective as DES for treating small vessel CAD after three years of follow up.

Coronary artery disease (CAD) is caused by blockages in the blood vessels of the heart. When these vessels become blocked it can lead to heart attack, heart failure, or death. A common treatment for CAD is inserting a drug-eluting stent (DES). DES involves inserting a tube-like structure into the blocked blood vessel to keep it open. The stent slowly releases an anti-clotting drug and prevents blood clots to form and block the vessel again. 

A more recent treatment that has been developed is the drug-coated balloon (DCB). DCB involves inserting a balloon which is coated in an anti-clotting drug into the artery. The drug sticks to the artery walls and the balloon can then be removed. Research has shown that DCB is as effective as DES in treating small vessel CAD after one year. However, it has not been shown if it is as effective in the long term.

This study involved 758 patients with CAD in small blood vessels (under 3 mm). They were randomly assigned to treatment with either DES (376) or DCB (382). Patients were followed up for 3 years.

The rate of major heart events such as heart attack, death, major bleeding, or the treated blood vessel becoming blocked again after 3 years was 15% in both groups. The rate of each of these outcomes separately was similar in both groups.  

This study showed that for CAD in small vessels DCB is as safe and effective as DES after 3 years.

This study followed up patients for three years which is quite a long period, but further studies may be needed to see if the effect is the same after a longer period.