title: Drug-Coated Balloons: A Safe and Effective Alternative to Drug-Eluting Stents in Small Vessel Coronary Artery Disease.
abstract: BACKGROUND
  Drug-coated balloons (DCB) have been used to treat de novo small vessel coronary disease (SVD), with promising results and shorter dual antiplatelet therapy (DAPT) duration compared to drug-eluting stents (DES). We compared safety and effectiveness of the two treatments at 1 year.
  
  
  METHODS
  We reviewed 3,613 angioplasty cases retrospectively from 2011 to 2013 and identified 335 patients with SVD treated with device diameter of ≤2.5 mm. DCB-only angioplasty was performed in 172 patients, whereas 163 patients were treated with second-generation DES.
  
  
  RESULTS
  DCB patients had smaller reference vessel diameter (2.22 ± 0.30 vs. 2.44 ± 0.19 mm, P < 0.001) and received smaller devices (median diameter 2.25 vs. 2.50 mm, P < 0.001) compared to the DES group. DES-treated vessels had larger acute lumen gain (1.71 ± 0.48 mm) than DCB (1.00 ± 0.53 mm, P < 0.001). Half the patients had diabetes mellitus. While there were more patients presenting with acute coronary syndrome (ACS) in the DCB group (77.9% vs. 62.2%, P = 0.013), they received shorter DAPT (7.4 ± 4.7 vs. 11.8 ± 1.4 months, P < 0.001) than the DES group. The 1-year composite major adverse cardiac event rate was 11.6% in the DCB arm and 11.7% in the DES arm (P = 1.000), with target lesion revascularization rate of 5.2% and 3.7%, respectively, (P = 0.601).
  
  
  CONCLUSIONS
  In this high-risk cohort of patients, DCB-only angioplasty delivered good clinical outcome at 1 year. The results were comparable with DES-treated patients, but had the added benefit of a shorter DAPT regime.
authors: Tan Tock Seng Hospital, Singapore. lukas_dasdo@yahoo.com.
authors: Dasdo Antonius
authors: DA
authors: Sinaga
authors: Tan Tock Seng Hospital, Singapore. lukas_dasdo@yahoo.com.
authors: Hee Hwa
authors: HH
authors: Ho
authors: Tan Tock Seng Hospital, Singapore.
authors: Timothy James
authors: TJ
authors: Watson
authors: Tan Tock Seng Hospital, Singapore.
authors: Alyssa
authors: A
authors: Sim
authors: Tan Tock Seng Hospital, Singapore.
authors: Thuzar Tint
authors: TT
authors: Nyein
authors: Tan Tock Seng Hospital, Singapore.
authors: Fahim H
authors: FH
authors: Jafary
authors: Tan Tock Seng Hospital, Singapore.
authors: Jason K K
authors: JK
authors: Loh
authors: Tan Tock Seng Hospital, Singapore.
authors: Yau Wei
authors: YW
authors: Ooi
authors: Tan Tock Seng Hospital, Singapore.
authors: Julian K B
authors: JK
authors: Tan
authors: Tan Tock Seng Hospital, Singapore.
authors: Paul J L
authors: PJ
authors: Ong
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D023903:Coronary Restenosis / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011474:Prosthesis Design; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome