Comparison of efficacy and safety of different revascularization strategies in patients with coronary athero-sclerotic heart disease in the real world
Gong Qiang
Xu Qiaoling
Han Yazhu
Abstract：Objective To compare the efficacy and safety of percutaneous transluminal coronary angio-plasty(PTCA)alone,drug-eluting stents(DES)and drug-coated balloons(DCB)in patients with coronary atherosclerotic heart disease in the real world.Methods A retrospective cohort study was conducted.Patients with coronary heart disease who underwent interventional therapy in Baoding No.1 Central Hospital,Hebei Province from January 2022 to October 2024 were enrolled and divided into PTCA group,DES group and DCB group according to surgical methods.Propensity score matching was used to balance baseline data among groups at a ratio of 1∶1∶1,and finally 70 patients were included in each group.The primary efficacy endpoint was major adverse cardiovascular events(MACE,including cardiac death,non-fatal myocardial infarction and ischemia-driven target lesion revascularization)within 1 year after operation.Safety endpoints included bleeding academic research consortium type 2-5 bleeding and in-stent thrombosis.Results The surgical success rates were high in all three groups[92.9％(65/70)in PTCA group vs 97.1％(68/70)in DES group vs 98.6％(69/70)in DCB group,P=0.185].During follow-up,there was no significant difference in the incidence of MACE among PTCA group,DES group and DCB group[20.0％(14/70)vs 17.1％(12/70)vs 8.6％(6/70)](P=0.147).In terms of safety,the incidence of bleeding events was lower in PTCA group[10.0％(7/70)],and no in-stent thrombosis occurred.Multivariate Cox regression analysis showed that age(per 1-year increase),diabetes mellitus,acute coronary syndrome,lesion type(B2/C type)and target lesion vessel being left anterior descending artery were risk factors for MACE(all P＜0.05).Conclusion In real-world clinical practice,in a propensity score-matched cohort of coronary heart disease patients,PTCA alone,as a representative of the"intervention without implantation"concept,shows favorable application value in specific lesions.Its surgical success rate is comparable to that of DES and DCB,and it has safety advantages of lower bleeding risk and zero in-stent thrombosis.Revascularization strategies should be reasonably selected according to lesion characteristics and individual patient conditions,and PTCA remains an important treatment option for specific populations.
Keywords：Coronary atherosclerotic heart diseasePercutaneous transluminal coronary angioplastyDrug-eluting stentDrug-coated balloonMajor adverse cardiovascular eventsBleeding risk
Publication Date：2026-06-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：6( 811-816 )