A total of 210 patients with
NSTEMI were enrolled in a randomised, controlled, non-inferiority multicentre trial comparing a
paclitaxel iopromide-coated DCB with primary
stent treatment. The main inclusion criterion was an identifiable culprit lesion without angiographic evidence of large
thrombus. The primary endpoint was target lesion failure (TLF; combined clinical endpoint consisting of cardiac or unknown death, reinfarction, and target lesion revascularisation) after nine months. Secondary endpoints included total major adverse cardiovascular events (
MACE) and individual clinical endpoints. Mean age was 67±12 years, 67% were male, 62% had multivessel disease, and 31% were diabetics. One hundred and four patients were randomised to DCB, 106 to
stent treatment. In the
stent group, 56% of patients were treated with BMS, 44% with current-generation DES. In the DCB group, 85% of patients were treated with DCB only whereas 15% underwent additional
stent implantation. During a follow-up of 9.2±0.7 months, DCB treatment was non-inferior to
stent treatment with a TLF rate of 3.8% versus 6.6% (intention-to-treat, p=0.53). There was no significant difference between BMS and current-generation DES. The total
MACE rate was 6.7% for DCB versus 14.2% for
stent treatment (p=0.11), and 5.9% versus 14.4% in the per protocol analysis (p=0.056), respectively.
CONCLUSIONS: In patients with
NSTEMI, treatment of coronary de novo lesions with DCB was non-inferior to stenting with BMS or DES. These data warrant further investigation of DCB in this setting, in larger trials with DES as comparator (ClinicalTrials.gov Identifier: NCT01489449).