Volume 106, Issue 1 pp. 625-632
ORIGINAL ARTICLE - CLINICAL SCIENCE

Comparison of Sirolimus—Versus Paclitaxel-Coated Balloons in Coronary Artery Disease: One-Year Results of Two Real-World Prospective Registries

Selina Vlieger

Selina Vlieger

Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands

Department of Cardiology, ErasmusMC, Rotterdam, the Netherlands

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Jin M. Cheng

Jin M. Cheng

Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands

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Filippo Luca Gurgoglione

Filippo Luca Gurgoglione

Division of Cardiology, Parma University Hospital, Parma, Italy

DCB Academy, Milan, Italy

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Tay M. Heang

Tay M. Heang

Pantai Hospital Ayer Keroh, Melaka, Malaysia

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Alexander J. J. Ijsselmuiden

Alexander J. J. Ijsselmuiden

Department of Cardiology, Maastricht University Medical centre, Maastricht, the Netherlands

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Alfonso Ielasi

Alfonso Ielasi

IRCCS Ospedale Galeazzi Sant'Ambrogio, Milano, Italy

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Eric Boersma

Eric Boersma

Department of Cardiology, ErasmusMC, Rotterdam, the Netherlands

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Lee C. Yan

Lee C. Yan

Sultanah Aminah Johor Bahru, Johor, Malaysia

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Alessandro Sciahbasi

Alessandro Sciahbasi

Sandro Pertini Hospital, Rome, Italy

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Ramesh Singh

Ramesh Singh

University Malaya Medical Centre, Kuala Lumpur, Malaysia

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George Karavolias

George Karavolias

Metropolitan Hospital, Pireas, Greece

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Dario Gattuso

Dario Gattuso

Fondazione Ricerca e Innovazione Cardiovascolare, Milan, Italy

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Rohit M. Oemrawsingh

Rohit M. Oemrawsingh

Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands

Amphia Hospital, Breda, the Netherlands

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Bernardo Cortese

Corresponding Author

Bernardo Cortese

DCB Academy, Milan, Italy

Fondazione Ricerca e Innovazione Cardiovascolare, Milan, Italy

University Hospitals Cleveland Medical Center, Harrington Heart & Vascular Institute, Cleveland, Ohio, USA

Correspondence: Bernardo Cortese ([email protected])

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First published: 19 May 2025

ABSTRACT

Background

Paclitaxel-(PCB) and sirolimus-coated balloons (SCB) are used for treatment of in-stent restenosis (ISR) and de novo (DN) lesions. Studies comparing major adverse cardiac events (MACE) after PCB versus SCB are limited.

Aims

This study aims to contribute to this knowledge gap and enhance the understanding of optimal strategies for treating ISR and DN lesions.

Methods

EASTBOURNE and PEARL are large-scale, prospective clinical registries, evaluating the performance of drug-coated balloons. PEARL included patients who underwent percutaneous coronary intervention using Protege PCB and EASTBOURNE included patients treated with MagicTouch SCB in study centers in Europe and Asia. We combined these registries and used logistic regression analysis to assess the association between SCB/PCB and the likelihood of experiencing MACE, a composite of all-cause mortality, myocardial infarction (MI) and target-lesion revascularisation (TLR) at 1-year follow-up.

Results

Out of 2596 patients, MACE was observed more frequently in ISR lesions (n = 1292 patients, SCB:17.8% vs. PCB:14.1%, p = 0.12) versus DN lesions (n = 1304 patients, SCB:6.4% vs. PCB:6.1%, p = 1.00). The adjusted hazards ratio (HR) for MACE was 1.17 (95% CI: 0.59–1.23, p = 0.40). As regards DN lesions, no significant difference was found in MACE (SCB: 6.4% vs. PCB 6.1%, p = 1.00). The adjusted HR for MACE was 1.24 (95% CI: 0.20–2.01, p = 0.13). There were no differences in the individual components of the primary endpoint.

Conclusions

This real-world comparison demonstrated comparable outcomes between new-generation PCB and SCB in terms of MACE at 1-year follow-up, across different lesion settings.

Conflicts of Interest

Dr Cortese serves as Advisory Board member for Concept Medical. The other authors declare no conflicts of interest.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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