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<p>Drug-coated balloon (DCB)–based non-stent percutaneous coronary intervention (PCI) may allow shorter dual antiplatelet therapy (DAPT), but whether a ≤ 30-day regimen is associated with worse outcomes remains unclear, particularly in patients not receiving oral anticoagulants. We conducted a single-center retrospective cohort study of patients undergoing DCB-based non-stent PCI between April 2021 and December 2024. Patients receiving oral anticoagulants were excluded. Patients were classified into short DAPT (≤ 30&#xa0;days; n = 153) or standard DAPT (&gt; 30&#xa0;days; n = 184). All procedures were performed after optimal lesion preparation, frequently including debulking devices. The primary endpoint was 1-year major adverse cardiac events (MACE). Propensity score–based analyses and Kaplan–Meier methods were applied to evaluate time-to-event outcomes. A total of 337 patients were included. MACE occurred in 9/153 (5.9%) patients in the short-DAPT group and 12/184 (6.5%) in the standard-DAPT group. In unadjusted analyses, there was no significant difference between groups (OR 0.90, 95% CI 0.37–2.21). After adjustment, short DAPT was not associated with 1-year MACE (IPTW OR 0.97, 95% CI 0.40–2.32; SMRW OR 0.88, 95% CI 0.35–2.23). In the matched cohort (112 pairs), findings were consistent (OR 1.54, 95% CI 0.53–4.49). Kaplan–Meier analysis showed no significant difference between groups (log-rank p = 0.78), with no apparent early divergence between the curves. Short DAPT after DCB-based non-stent PCI in patients not receiving oral anticoagulants was not statistically associated with increased 1-year MACE. These findings should be interpreted cautiously given the observational design and potential residual confounding.</p> Graphical Abstract <p></p>

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Association between short (≤ 30-day) dual antiplatelet therapy and 1-year major adverse cardiac events after drug-coated balloon–based non-stent percutaneous coronary intervention following optimal lesion preparation: a propensity score–based cohort study

  • 期刊论文

  • 发表日期：

    2026年6月18日

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  • Shuhei Kuroda,
  • Takahiro Sawada,
  • Ryota Yui,
  • Koichi Nakamura,
  • Yoichiro Matsuoka,
  • Yuya Terao,
  • Tatsuro Ito,
  • Katsunori Okajima,
  • Makoto Kadotani,
  • Yoshio Onishi,
  • Ken-ichi Hirata

摘要

Drug-coated balloon (DCB)–based non-stent percutaneous coronary intervention (PCI) may allow shorter dual antiplatelet therapy (DAPT), but whether a ≤ 30-day regimen is associated with worse outcomes remains unclear, particularly in patients not receiving oral anticoagulants. We conducted a single-center retrospective cohort study of patients undergoing DCB-based non-stent PCI between April 2021 and December 2024. Patients receiving oral anticoagulants were excluded. Patients were classified into short DAPT (≤ 30 days; n = 153) or standard DAPT (> 30 days; n = 184). All procedures were performed after optimal lesion preparation, frequently including debulking devices. The primary endpoint was 1-year major adverse cardiac events (MACE). Propensity score–based analyses and Kaplan–Meier methods were applied to evaluate time-to-event outcomes. A total of 337 patients were included. MACE occurred in 9/153 (5.9%) patients in the short-DAPT group and 12/184 (6.5%) in the standard-DAPT group. In unadjusted analyses, there was no significant difference between groups (OR 0.90, 95% CI 0.37–2.21). After adjustment, short DAPT was not associated with 1-year MACE (IPTW OR 0.97, 95% CI 0.40–2.32; SMRW OR 0.88, 95% CI 0.35–2.23). In the matched cohort (112 pairs), findings were consistent (OR 1.54, 95% CI 0.53–4.49). Kaplan–Meier analysis showed no significant difference between groups (log-rank p = 0.78), with no apparent early divergence between the curves. Short DAPT after DCB-based non-stent PCI in patients not receiving oral anticoagulants was not statistically associated with increased 1-year MACE. These findings should be interpreted cautiously given the observational design and potential residual confounding.

Graphical Abstract