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DCB-based PCI in Multi-Vessel-Disease
Clinical impact of drug coated balloon-based percutaneous coronary intervention in patients with multivessel coronary artery disease
Significantly lower MACE rate in patients treated with SeQuent® Please (NEO) compared to DES
Shin ES et al. JACC Cardiovasc Interv. 2023;16(3):292-299
Overview
DCB (study device = SeQuent Please® (NEO)) in patients with MVD (2 or more coronary lesions) - Propensity score matched to patients receiving DES
Primary endpoint:
- MACE @24 months (cardiac death, MI, TVR, stroke, stent thrombosis and major bleeding)
Results
- In DCB-group 34.3 % of patients were treated with DCB-only, 65.7 % with hybrid PCI (DES+DCB)
- Stent-length was significantly reduced by 63.7 % in DCB-group
- MACE after 24 months was significantly lower in DCB-group vs. DES (3.9 % vs. 11 %; p=0.002)
| Total population: 508 patients | DCB-Based (n=254) | DES-only (n=254) | p-value |
| Clinical endpoint after 24 months | |||
| MACE | 3.9 % (10) | 11.0 % (28) | 0.002 |
| Cardiac death | 0.4 % (1) | 2.4 % (6) | 0.047 |
| MI | 0 | 1.2 % (3) | 0.082 |
| Stroke | 0 | 0.4 % (1) | 0.313 |
| ST (definite/probable) | 0 | 0.4 % (1) | 0.333 |
| TVR | 3.1 % (8) | 6.3 % (16) | 0.095 |
| Major bleeding | 0.4 % (1) | 2.8 % (7) | 0.027 |
Conclusion
The DCB-based treatment approach showed a significantly reduced stent burden in multivessel PCI and this led to a significantly lower rate of MACE than the DES-only treatment.