title: A propensity score matched comparative study between paclitaxel-coated balloon and everolimus-eluting stents for the treatment of small coronary vessels.
abstract: OBJECTIVE
  To compare the long-term clinical outcomes of paclitaxel drug-coated-balloons (DCB) and everolimus-eluting-stents (EES) following the treatment of de novo small vessel coronary artery disease.
  
  
  BACKGROUND
  It is currently unclear whether treatment of de novo small vessel coronary disease with DCB is comparable to second generation drug-eluting stents, which are the current standard of care.
  
  
  METHODS
  The present study enrolled 90 patients with small vessel coronary disease from the DCB treatment arm of the BELLO (Balloon Elution and Late Loss Optimization) trial and 2,000 patients treated with EES at the San Raffaele Scientific Institute. Propensity score matching was performed to adjust for differences in baseline clinical and angiographic characteristics, yielding a total of 181 patients: 90 patients with 94 lesions receiving DCB and 91 patients with 94 lesions receiving EES. Major adverse cardiac events (MACE) were defined as the composite of cardiac death, recurrent non-fatal myocardial infarction, and target vessel revascularization.
  
  
  RESULTS
  After propensity score matching, baseline clinical and angiographic characteristics were similar between the two groups. The cumulative MACE rate at 1-year was 12.2% with DCB and 15.4% with EES (P = 0.538). Patients in the DCB group had similar TLR rates as compared to EES over the same interval (4.4% vs. 5.6%; P = 0.720). There were no cases of definite or probable stent or vessel thrombosis.
  
  
  CONCLUSIONS
  The use of paclitaxel-DCB appears to be associated with similar clinical outcomes when compared to second-generation-EES in small coronary artery disease. The findings of this study should be confirmed with larger prospective randomized studies with longer follow-up. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giannini
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Marco B
authors.initials: MB
authors.lastname: Ancona
authors.affiliation: Department of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Charis
authors.initials: C
authors.lastname: Costopoulos
authors.affiliation: Hammersmith Hospital, Imperial NHS Healthcare Trust, London, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Ruparelia
authors.affiliation: Interventional Cardiology Unit, Cardiology Department, Ospedale di Parma, Parma, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Menozzi
authors.affiliation: Interventional Cardiology Unit, Città di Lecce Hospital, GVM Care and Research, Lecce, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Castriota
authors.affiliation: Interventional Cardiology Unit, Maria Eleonora Hospital, GVM Care and Research, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Micari
authors.affiliation: Interventional Cardiology Unit, Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cremonesi
authors.affiliation: Interventional Cardiology Unit, Ospedale San Camillo, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: De Felice
authors.affiliation: Interventional Cardiology Unit, Anthea Hospital, GVM Care and Research, Bari, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Marchese
authors.affiliation: Interventional Cardiology Unit, Ospedale Bolognini, Seriate, Bergamo, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Tespili
authors.affiliation: Interventional Cardiology Unit, Istituto Clinico Humanitas, Rozzano, Milan, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Presbitero
authors.affiliation: Interventional Cardiology Unit, Ospedale Santa Maria Goretti, Latina, Italy.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Sgueglia
authors.affiliation: Interventional Cardiology Unit, Ospedale di Mantova, Mantova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Buffoli
authors.affiliation: Interventional Cardiology Unit, Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.affiliation: Interventional Cardiology Unit, Ospedale di Rivoli, Torino, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Varbella
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D062906:Cardiac Catheters; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016009:Chi-Square Distribution; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017239:Paclitaxel / Q000008:administration & dosage* / Q000009:adverse effects; D057216:Propensity Score; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D020099:Coated Materials, Biocompatible; D000068338:Everolimus; D017239:Paclitaxel
keywords: drug-coated balloon; second-generation drug-eluting stent; small coronary vessel disease