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
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 comprehensiv...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-023-03633-w |
| _version_ | 1827382383142240256 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Ahmed Abdelaziz |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T14:18:46Z |
| format | Article |
| id | doaj.art-08aa4d8375ef4f0490e2b6916d13cea5 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-03-08T14:18:46Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-08aa4d8375ef4f0490e2b6916d13cea52024-01-14T12:11:09ZengBMCBMC Cardiovascular Disorders1471-22612023-12-0123111610.1186/s12872-023-03633-wDrug-coated balloons versus drug-eluting stents in patients with acute myocardial infarction undergoing percutaneous coronary intervention: an updated meta-analysis with trial sequential analysisAhmed Abdelaziz0Abdelrahman Hafez1Karim Atta2Hanaa Elsayed3Mohamed Abdelaziz4Ahmed Elaraby5Hallas Kadhim6Ahmed Mechi7Mahmoud Ezzat8Ahmed Fadel9Ahmed Nasr10Ali Bakr11Hazem S. Ghaith12Medical Research Group of Egypt (MRGE)Medical Research Group of Egypt (MRGE)Medical Research Group of Egypt (MRGE)Medical Research Group of Egypt (MRGE)Medical Research Group of Egypt (MRGE)Medical Research Group of Egypt (MRGE)Al Muthanna University College of MedicineMedicine College, Internal Medicine Department, University of KufaMedical Research Group of Egypt (MRGE)Medical Research Group of Egypt (MRGE)Faculty of Medicine, Al-Azhar UniversityMedical Research Group of Egypt (MRGE)Medical Research Group of Egypt (MRGE)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.https://doi.org/10.1186/s12872-023-03633-wAMIPCIDCBDESTSAMeta-analysis |
| spellingShingle | 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 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 BMC Cardiovascular Disorders AMI PCI DCB DES TSA Meta-analysis |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | AMI PCI DCB DES TSA Meta-analysis |
| url | https://doi.org/10.1186/s12872-023-03633-w |
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