Efficacy of Drug Coated Balloon versus Drug Eluting Stent for Patients with De Novo Coronary Artery Disease: A Systematic Review and Meta-Analysis

• Published in: Medical principles and practice pp. 1 - 16
• Main Authors: Haq, Affan Ul, Suhail, Amina, Ahsan, Waseh, Maqbool, Hamza, Nawal, Ayesha, Hassan, Hamza, Bungish, Musa Khan, Shahid, Muhammad Ali, Wazir, Hakim Ullah, Yousaf, Humayoun, Rehman, Mohammad Ebad Ur, Ahmad Cheema, Huzaifa, Alsubari, Asma'a Munasar Ali, Khan, Muhammad Aslam, Nadeem, Bilawal, Ahmed, Raheel, Ahmad, Adeel
• Format: Journal Article
• Language: English
• Published: Switzerland S. Karger AG 27.06.2025
• Subjects: Systematic Review; Percutaneous coronary intervention; Drug-coated balloons; Drug-eluting stents
• DOI: 10.1159/000547099
• ISSN: 1011-7571; 1423-0151

Objectives: This meta-analysis compared the efficacy and safety of drug coated balloon (DCB) angioplasty with drug eluting stent (DES) for the treatment of de novo coronary artery disease. Methods: Following PRISMA guidelines, we conducted a systematic search of major databases, including Cochrane, MEDLINE, Embase and clinicaltrials.gov, to identify eligible randomized controlled trials (RCTs) comparing DCB and DES. Mantel-Haenszel model was used for dichotomous outcomes. Risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effects model using RevMan software. Results: Thirteen RCTs with a total of 4,686 patients were included. The analysis found no significant differences between DCB and DES for all-cause mortality (RR: 1.11, 95% CI: 0.81–1.53, p = 0.51) or myocardial infarction (RR: 0.80, 95% CI: 0.56–1.15, p = 0.23). Similarly, no significant differences were observed for cardiac death (RR: 1.33, 95% CI: 0.86–2.05, p = 0.19), target lesion revascularization (RR: 1.19, 95% CI: 0.64–2.21, p = 0.59), or target vessel revascularization (RR: 1.34, 95% CI: 0.79–2.28, p = 0.28). Conclusion: This meta-analysis demonstrates comparable efficacy and safety outcomes for DCBs and DES in the treatment of de novo coronary artery disease. While DCBs offer a viable alternative, particularly for high-risk patients or those unsuitable for prolonged dual antiplatelet therapy, further large-scale studies are warranted to strengthen these findings and refine clinical recommendations.