Author + information
- Wenhao Liu1,
- Shaohua Wang1,
- Chengzhang Xu1,
- Haifeng Zhang1,
- Yongqing Lin1,
- Yangxin Chen1 and
- Jingfeng Wang1
Both drug-coated balloon (DCB) and drug-eluting stent (DES) were used for treatment of in-stent restenosis but it is unclear about their effects of magnitude. We therefore performed a meta-analysis to compare the long-term outcomes between DCB angioplasty and DES implantation for patients with coronary in-stent restenosis (ISR).
Data sources were all collected from PubMed, the Cochrane Central Register of Controlled Trials, Ovid and EMBASE on April, 1st, 2017. Only randomized controlled trials were enrolled. Data on study design, quality, patient characteristics, length of follow-up duration and outcomes were pooled and analyzed. For duplicate publications, outcomes were obtained from the publication with the longest follow-up.
Prespecified criteria were met by 8 trials involving 1613 patients. There was no significant difference in major adverse cardiac events between groups (risk ratio, RR, 1.04, P = 0.699), myocardial infarction (RR = 1.17, P = 0.598) and target lesion revascularization (RR = 1.24, P = 0.085) in overall analyses. However, when analysis was done in ISR patients with DES implanted previously, the incidence of target lesion revascularization in the DCB group was much higher than those in the DES group (RR = 1.41, P = 0.012). No publication bias was detected.
DES implantation is superior to DCB angioplasty in DES-ISR patients. Further studies are merited to assess these associations in greater details, especially those with endpoints of major adverse cardiac events.