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Drug-coated balloons versus drug-eluting stents in patients with acute myocardial infarction undergoing percutaneous coronary intervention: an updated meta-analysis with trial sequential analysis

Authors :
Ahmed Abdelaziz
Abdelrahman Hafez
Karim Atta
Hanaa Elsayed
Mohamed Abdelaziz
Ahmed Elaraby
Hallas Kadhim
Ahmed Mechi
Mahmoud Ezzat
Ahmed Fadel
Ahmed Nasr
Ali Bakr
Hazem S. Ghaith
Source :
BMC Cardiovascular Disorders, Vol 23, Iss 1, Pp 1-16 (2023)
Publication Year :
2023
Publisher :
BMC, 2023.

Abstract

Abstract Background Drug-coated balloons (DCBs) are an established strategy for coronary artery disease. However, the new generation drug-eluting stent (DES) is recommended for patients with Acute myocardial infarction (AMI) for coronary artery revascularization. Our aim is to provide a comprehensive appraisal of the efficacy of DCBs in patients with AMI undergoing PCI. Methods We searched the WOS, PubMed, Scopus, and Cochrane CENTRAL till March 2023, for studies that compared DCBs versus DES in patients with AMI undergoing PCI. We used a random-effects model to compare major adverse cardiac events (MACE), cardiac death, all-cause death, myocardial infarction, target lesion revascularization (TLR), stent thrombosis, Late lumen Loss (LLL), and minimum lumen diameter (MLD) between the two groups. Results Thirteen studies comprising 2644 patients were included. The pooled OR showed non-inferiority of DCB over DES in terms of MACE (OR = 0.89, 95% CI [0.57 to 1.40], p = 0.63). When we defined MACE as a composite of cardiac death, MI, and TLR; the pooled OR favored DCB over DES (OR = 0.50, 95% CI [0.28 to 0.9], p = 0.02). Moreover, DCB was not inferior to DES in terms of all-cause mortality (OR = 0.88, 95% CI: 0.43 to 1.8, p = 0.73), cardiac mortality, (OR = 0.59, 95% CI: 0.22 to 1.56, p = 0.29), MI (OR = 0.88, 95% CI: 0.34 to 2.29, p = 0.79), stent thrombosis (OR = 1.21, 95% CI: 0.35 to 4.23, p = 0.76), TLR (OR = 0.9, 95% CI: 0.43 to 1.93, p = 0.8), LLL (MD = -0.6, 95% CI: -0.3 to 0.19, p = 0.64), or MLD (MD = -0.4, 95% CI: -0.33 to 0.25, p = 0.76). Conclusion Our meta-analysis indicated that DCB intervention was not inferior to DES in the PCI setting in patients with AMI, and can be recommended as a feasible strategy in AMI. PROSPERO registration CRD42023412757.

Details

Language :
English
ISSN :
14712261
Volume :
23
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Cardiovascular Disorders
Publication Type :
Academic Journal
Accession number :
edsdoj.08aa4d8375ef4f0490e2b6916d13cea5
Document Type :
article
Full Text :
https://doi.org/10.1186/s12872-023-03633-w