Long-term performance of drug-coated balloons and drug-eluting stents in diabetic patients with in-stent restenosis

AIM To investigate the relationship between two different treatment approaches, drug-eluting stents (DES) and drug-coated balloons (DCB), and the clinical prognosis of patients with diabetes mellitus (DM) complicated by in-stent restenosis (ISR).

METHODS A total of 700 patients diagnosed with DM and ISR who underwent PCI at Xijing Hospital between June 1, 2015, and June 1, 2020 were enrolled. Among them, 380 patients (54.3%) underwent DES-only treatment, while 320 patients (45.7%) received DCB-only treatment. The primary endpoint was device-oriented composite endpoint (DoCE), defined as a composite endpoint of cardiovascular death, non-fatal target vessel MI (TV-MI), and target lesion revascularization (TLR).

RESULTS At 36 months follow-up,the cumulative incidence of the primary endpoint (DoCE) in the DES group (8.7%) was significantly lower than DCB group (18.8%)(P<0.05). Similarly, the cumulative incidence of the secondary endpoint (PoCE) in the DES group (12.9%) was significantly lower than DCB group (25.0%)(P<0.05).

CONCLUSION The rates of both DoCE and PoCE are higher in patients with DM and ISR who were treated with DCB compared to DES.