Efficacy Of Drug-coated Balloon For Treating The De Novo Lession In Large Vessels:A Meta Analysis

Background:In recent years,drug coated balloon(DCB)has been widely used in percutaneous coronary intervention.Now,the efficacy and safety of DCB have been demonstrated in the treatment of in-stent restenosis,bifurcated lesions and small vessel lesions of coronary arteries.However,there are few studies on the efficacy of DCB in the treatment of large de novo cornary vessel lesions.Methods:We searched studies in PubMed,EMBASE,CNKI,Wanfang,and VIP databases by computer,and selected all the clinical trials related to DCB in treating de novo lession in large vessels.The endpoint was the late lumen loss(LLL)and major adverse cardiovascular events(MACE)after the DCB treatment.RevMan 5.2 was uesed for Meta analysis.Results:1426 patients with coronary heart disease were included in11 studies,including 775 patients treated with DCB.The follow-up time ranged from 6 to 12 months.A meta-analysis of late lumen loss showed that I~2=76.9%,reflecting the heterogeneity between the studies.For subgroup analysis,the heterogeneity between the large versus small vessel groups was relatively small(I~2=0,P=0.78,95%CI 0.01-0.02),and there was still heterogeneity in the drug coated balloon versus stent contrast test(I~2=100%,P<0.00001,95%CI:-0.08~-0.010).After the sensitivity analysis,the deviation is stable.There is no significant difference in the incidence of MACEs between two groups(I~2=8%,P=0.37,95%CI:0.41-1.40),indicating that there is no significant difference in the clinical efficacy between the two groups.Conclusion:DCB may be effective in the treatment of de novo lesions in large vessels,but more randomized controlled trials and long-term follow-up are needed.