Clinical impact of drug-coated balloon treatment of coronary artery disease in elderly patients
Eun-Seok SHIN
Mi Hee JANG
Sunwon KIM
Dong Oh KANG
Ki-Bum WON
Bitna KIM
Ae-Young HER
Abstract：Background Data on drug-coated balloon (DCB) treatment in elderly patients are limited. This study was to evaluate the efficacy of DCB treatment in percutaneous coronary intervention (PCI) among elderly patients.
Methods A retrospective analysis included 232 patients aged 75 years or older with coronary artery disease who underwent successful PCI using either DCB alone or in combination with drug-eluting stent (DES) based on pre-dilation results (DCB-based PCI). These patients were compared with 1818 elderly patients who underwent second-generation DES implantation (DES-only PCI). The endpoint was major adverse cardiovascular events (MACE) at 2-year follow-up.
Results In the DCB-based PCI, 61.2% of patients received DCB-only treatment. Compared to DES-only PCI, the DCB-based PCI group had fewer stents (0.5±0.7 and 1.7±0.8, P＜0.001), shorter stent lengths (13.3±20.9 mm and 37.4±23.0 mm, P＜0.001), and lower usage of small stents with a diameter of 2.5 mm or less (15.6% and 28.7%, P=0.010). The DCB-based PCI group exhibited lower rate of MACE (5.5% and 13.1%, P=0.003), target vessel revascularization (1.1% and 5.6%, P=0.017) and major bleeding (0.7% and 5.1%, P=0.009) at 2-year follow-up. The reduced risk in 2-year MACE was consistently observed across various matching procedures, with the most significant reduction noted in target vessel revascularization and major bleeding.
Conclusion The DCB-based PCI reduced stent burden, particularly in the usage of small diameter stents, and was associated with lower risks of MACE, target vessel revascularization, and major bleeding compared to DES-only PCI in elderly patients.
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Publication Date：2025-01-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：9( 150-158 )