Drug-coated balloon: A better revascularization strategy in patients with multivessel coronary artery disease undergoing one-stop hybrid coronary revascularization surgery.

Abstract

The optimal revascularization strategy for non- left anterior descending coronary artery (LAD) lesions during one-stop hybrid coronary revascularization (HCR) surgery remains "evidence-free". This study aimed to compare the outcomes of drug-coated balloon (DCB) and drug-eluting stent (DES) strategy in patients with non-small non-LAD lesions undergoing one-stop HCR. A total of 141 consecutive patients with multivessel coronary artery disease (MVCAD) undergoing one-stop HCR between 1 June 2018 and 1 March 2022 were retrospectively included in this study. In-hospital outcomes and mid-term major adverse cardiovascular and cerebrovascular events (MACCE) were observed. Kaplan-Meier curve analysis was used to evaluate MACCE-free survival rate. Cox proportional hazard model was used to identify risk factors of mid-term MACCE. 38 and 103 patients received only DCB or DES therapy in this study. There were no significant differences in demographic characteristics and laboratory parameters between two groups. The in-hospital MACCE rate of DES group was numerically higher than that of DCB group (9.7% vs. 5.3%), but the difference was not statistically significant (P=0.4). The incidence of MACCE after patients' discharge was significantly higher in DES group (22% vs. 5.3%, P=0.02) during a median follow-up time of 20 months. After multivariable Cox proportional hazard analysis, DCB therapy was independently associated with the reduced risk of mid-term MACCE (hazard ratio=0.21, 95% CI 0.06-0.91, P =0.04). For patients with MVCAD undergoing one-stop HCR, DCB therapy may be the optimal revascularization strategy for non-small non-LAD coronary artery lesions with significantly lower rate of mid-term MACCE.