ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Clinical outcomes of drug-coated balloon vs. second-generation drug-eluting stent for coronary in-stent restenosis.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCurrent guideline recommendations for the treatment of coronary in-stent restenosis (ISR) are primarily based on evidence from smaller, randomized trials comparing drug-coated balloons (DCBs) and second-generation drug-eluting stents (DES). PURPOSE: The purpose was to compare clinical outcomes between DCB and DES in routine clinical practice.
methodsIn this population-based cohort study, we identified 10,292 patients with ISR who underwent either DCB or DES intervention. After 1:1 propensity score matching, 3942 patients treated with either DCB or second-generation DES were included in the analysis. The composite primary end point was all-cause mortality or myocardial infarction (MI) at 1 year. Secondary end points included each component of the primary end point. The safety end point was defined by hospitalization due to bleeding events.
resultsAt 1-year follow-up, the primary outcome occurred in 10.4% (n = 206) of the DCB group versus 12.9% (n = 254) of the DES group (HR, 0.77; 95% CI, 0.64-0.93). Among secondary outcomes, all-cause mortality was lower in the DCB group (6.3%, n = 125) compared to the DES group (8.1%, n = 160; HR, 0.75; 95% CI, 0.59-0.94), as was hospitalization for bleeding (2.5%, n = 50 vs. 4.2%, n = 82; HR, 0.65; 95% CI, 0.45-0.96). Rates of MI were similar between groups (HR, 0.83; 95% CI, 0.63-1.10).
conclusionDCBs were associated with lower rates of the primary end point all-cause death or myocardial infarction, as well as secondary end points all-cause death and bleeding compared with second-generation DES. These findings suggest that DCBs may represent a safe and effective alternative to DES in selected patient populations.
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