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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.

Titel:	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.
Autor/in / Beteiligte Person:	Abdelaziz, A ; Hafez, A ; Atta, K ; Elsayed, H ; Abdelaziz, M ; Elaraby, A ; Kadhim, H ; Mechi, A ; Ezzat, M ; Fadel, A ; Nasr, A ; Bakr, A ; Ghaith, HS
Link:	View record at Springer (Volltext)
Zeitschrift:	BMC cardiovascular disorders, Jg. 23 (2023-12-08), Heft 1, S. 605
Veröffentlichung:	London : BioMed Central, [2001-, 2023
Medientyp:	academicJournal
ISSN:	1471-2261 (electronic)
DOI:	10.1186/s12872-023-03633-w
Schlagwort:	Humans Treatment Outcome Death Percutaneous Coronary Intervention adverse effects Drug-Eluting Stents adverse effects Myocardial Infarction diagnosis Myocardial Infarction therapy Myocardial Infarction etiology Coronary Artery Disease diagnostic imaging Coronary Artery Disease therapy Coronary Artery Disease complications Thrombosis etiology
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Meta-Analysis; Journal Article Language: English [BMC Cardiovasc Disord] 2023 Dec 08; Vol. 23 (1), pp. 605. <i>Date of Electronic Publication: </i>2023 Dec 08. MeSH Terms: Percutaneous Coronary Intervention* / adverse effects ; Drug-Eluting Stents* / adverse effects ; Myocardial Infarction* / diagnosis ; Myocardial Infarction* / therapy ; Myocardial Infarction* / etiology ; Coronary Artery Disease* / diagnostic imaging ; Coronary Artery Disease* / therapy ; Coronary Artery Disease* / complications ; Thrombosis* / etiology ; Humans ; Treatment Outcome ; Death Comments: Erratum in: BMC Cardiovasc Disord. 2024 Jan 8;24(1):36. (PMID: 38191295) References: Ibanez B, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2018;39(2):119–77. https://doi.org/10.1093/eurheartj/ehx393 . 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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.