Drug-Coated Balloons versus Everolimus-Eluting Stents in Patients with In-Stent Restenosis: A Pair-Wise Meta-Analysis of Randomized Trials

Objective. This study aimed to compare the effectiveness of drug-coated balloons (DCB) with everolimus-eluting stents (EES) in the treatment of in-stent restenosis (ISR) and the differential relative effect of DCB in patients with drug-eluting stents (DES)-ISR and bare metal stents (BMS)-ISR. Backgr...

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Main Authors: Nina Peng, Wei Liu, Zongzhuang Li, Jun Wei, Xuejun Chen, Wei Wang, Hao Lin
Format: Article
Language:English
Published: Hindawi-Wiley 2020-01-01
Series:Cardiovascular Therapeutics
Online Access:http://dx.doi.org/10.1155/2020/1042329
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spelling doaj-e6ed6b113b4a4beeb28d64cfbd206c632020-11-25T01:49:01ZengHindawi-WileyCardiovascular Therapeutics1755-59141755-59222020-01-01202010.1155/2020/10423291042329Drug-Coated Balloons versus Everolimus-Eluting Stents in Patients with In-Stent Restenosis: A Pair-Wise Meta-Analysis of Randomized TrialsNina Peng0Wei Liu1Zongzhuang Li2Jun Wei3Xuejun Chen4Wei Wang5Hao Lin6Department of Internal Medicine, Guizhou Orthopedics Hospital, Guiyang, ChinaDepartment of Cardiology, Guizhou Provincial People’s Hospital, Guiyang, ChinaDepartment of Cardiology, Guizhou Provincial People’s Hospital, Guiyang, ChinaDepartment of Internal Medicine, Guizhou Orthopedics Hospital, Guiyang, ChinaDepartment of Internal Medicine, Guizhou Orthopedics Hospital, Guiyang, ChinaDepartment of Internal Medicine, Guizhou Orthopedics Hospital, Guiyang, ChinaDepartment of Internal Medicine, Guizhou Orthopedics Hospital, Guiyang, ChinaObjective. This study aimed to compare the effectiveness of drug-coated balloons (DCB) with everolimus-eluting stents (EES) in the treatment of in-stent restenosis (ISR) and the differential relative effect of DCB in patients with drug-eluting stents (DES)-ISR and bare metal stents (BMS)-ISR. Background. The efficiency and safety of DCB and EES need to be assessed for the treatment of ISR. Methods. A systematic literature search was conducted using PubMed and EMBASE to identify all relevant studies. Angiographic results and clinical events were separately assessed. Subgroup meta-analyses were performed according to the type of restenosed stent. Results. Six randomized trials with 1134 patients were included. The overall pooled outcomes indicated that DCB was associated with lower minimum lumen diameter (mean difference MD=−0.17, 95% CI = −0.29 to −0.05, P=0.006) and higher target lesion revascularization (risk ratio RR=2.38, 95% CI = 1.36 to 4.18, P=0.002) than EES. However, the subgroup meta-analyses showed that DCB was inferior to EES only in DES-ISR patients, with lower minimum lumen diameter (MD=−0.25, 95% CI = −0.37 to −0.14, P<0.001), higher percent diameter stenosis (MD=5.37, 95% CI = 1.33 to 9.42, P=0.009), more binary restenosis (RR=2.07, 95% CI = 1.20 to 3.58, P=0.009), and higher incidence of target vessel revascularization (RR=2.07, 95% CI = 1.22 to 3.50, P=0.007) and target lesion revascularization (RR=2.43, 95% CI = 1.28 to 4.22, P=0.002). No differences in angiographic results and clinical events were found between DCB and EES in BMS-ISR patients. Conclusions. DCB was inferior to EES in DES-ISR and comparable in BMS-ISR in terms of angiographic results and clinical events.http://dx.doi.org/10.1155/2020/1042329
collection DOAJ
language English
format Article
sources DOAJ
author Nina Peng
Wei Liu
Zongzhuang Li
Jun Wei
Xuejun Chen
Wei Wang
Hao Lin
spellingShingle Nina Peng
Wei Liu
Zongzhuang Li
Jun Wei
Xuejun Chen
Wei Wang
Hao Lin
Drug-Coated Balloons versus Everolimus-Eluting Stents in Patients with In-Stent Restenosis: A Pair-Wise Meta-Analysis of Randomized Trials
Cardiovascular Therapeutics
author_facet Nina Peng
Wei Liu
Zongzhuang Li
Jun Wei
Xuejun Chen
Wei Wang
Hao Lin
author_sort Nina Peng
title Drug-Coated Balloons versus Everolimus-Eluting Stents in Patients with In-Stent Restenosis: A Pair-Wise Meta-Analysis of Randomized Trials
title_short Drug-Coated Balloons versus Everolimus-Eluting Stents in Patients with In-Stent Restenosis: A Pair-Wise Meta-Analysis of Randomized Trials
title_full Drug-Coated Balloons versus Everolimus-Eluting Stents in Patients with In-Stent Restenosis: A Pair-Wise Meta-Analysis of Randomized Trials
title_fullStr Drug-Coated Balloons versus Everolimus-Eluting Stents in Patients with In-Stent Restenosis: A Pair-Wise Meta-Analysis of Randomized Trials
title_full_unstemmed Drug-Coated Balloons versus Everolimus-Eluting Stents in Patients with In-Stent Restenosis: A Pair-Wise Meta-Analysis of Randomized Trials
title_sort drug-coated balloons versus everolimus-eluting stents in patients with in-stent restenosis: a pair-wise meta-analysis of randomized trials
publisher Hindawi-Wiley
series Cardiovascular Therapeutics
issn 1755-5914
1755-5922
publishDate 2020-01-01
description Objective. This study aimed to compare the effectiveness of drug-coated balloons (DCB) with everolimus-eluting stents (EES) in the treatment of in-stent restenosis (ISR) and the differential relative effect of DCB in patients with drug-eluting stents (DES)-ISR and bare metal stents (BMS)-ISR. Background. The efficiency and safety of DCB and EES need to be assessed for the treatment of ISR. Methods. A systematic literature search was conducted using PubMed and EMBASE to identify all relevant studies. Angiographic results and clinical events were separately assessed. Subgroup meta-analyses were performed according to the type of restenosed stent. Results. Six randomized trials with 1134 patients were included. The overall pooled outcomes indicated that DCB was associated with lower minimum lumen diameter (mean difference MD=−0.17, 95% CI = −0.29 to −0.05, P=0.006) and higher target lesion revascularization (risk ratio RR=2.38, 95% CI = 1.36 to 4.18, P=0.002) than EES. However, the subgroup meta-analyses showed that DCB was inferior to EES only in DES-ISR patients, with lower minimum lumen diameter (MD=−0.25, 95% CI = −0.37 to −0.14, P<0.001), higher percent diameter stenosis (MD=5.37, 95% CI = 1.33 to 9.42, P=0.009), more binary restenosis (RR=2.07, 95% CI = 1.20 to 3.58, P=0.009), and higher incidence of target vessel revascularization (RR=2.07, 95% CI = 1.22 to 3.50, P=0.007) and target lesion revascularization (RR=2.43, 95% CI = 1.28 to 4.22, P=0.002). No differences in angiographic results and clinical events were found between DCB and EES in BMS-ISR patients. Conclusions. DCB was inferior to EES in DES-ISR and comparable in BMS-ISR in terms of angiographic results and clinical events.
url http://dx.doi.org/10.1155/2020/1042329
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