Objectives To investigate the safety and efficacy of drug-coated balloon(DCB)applied to the de-novo large coronary vessel lesions of elderly patients with high bleeding risk(HBR).Methods The clinical data of 525 elderly patients with coronary heart disease at HBR who underwent non-emergency percutaneous coronary intervention(PCI)in Wuhan Asian Heart Hospital from January 2018 to December 2020 were analyzed retrospectively.The case-control study was used.Depending on the method of PCI,57 cases were divided into experimental(DCB)group and 468 cases were divided into control(drug-eluting stent,DES)group.The incidence of major adverse cardiovascular events(MACE),including target lesion revascularization(TLR),recurrent myocardial infarction,cardiogenic death and bleeding events,was compared between the two groups.All the patients were followed up for 12 months.Results There were no significant differences in smoking,complicated medical diseases(hypertension,hyperlipidemia,diabetes,hyperuricemia),creatinine and left ventricular ejection fraction(LVEF)between DCB group and DES group(all P>0.05).There were no significant differences in the number of basal lesion vessels,target lesion vessels,preoperative stenosis degree of target lesion,and length of target lesion between the two groups(all P>0.05).The success rate of PCI in the two groups was 100%.The results of 12-month follow-up showed that there was a significant difference in the incidence of MACE between DCB group and DES group[8.8%vs.24.0%].There was no significant difference in the rate of recurrent myocardial infarction,cardiac death and target lesion revascularization(TLR)events between the two groups(both P>0.05).The incidence of bleeding events in DCB group was significantly lower than that in DES group(P<0.05).Conclusions DCB are not inferior to DES in the treatment of de-novo large coronary vessel lesions in elderly patients with HBR,and it can reduce the risk of bleeding events.
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