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Drug-Coated Balloon-Based Intervention for De Novo Acute Myocardial Infarction

Ae-Young Her1, Sunwon Kim2, Dong Oh Kang3

  • 1Division of Cardiology, Department of Internal Medicine, Kangwon National University College of Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.

Yonsei Medical Journal
|November 25, 2025
PubMed

Insights

Drug-coated balloon (DCB) treatment for acute myocardial infarction (AMI) showed better outcomes than drug-eluting stents (DES). DCB PCI significantly reduced major adverse cardiovascular events, revascularization, and bleeding in AMI patients over two years.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomaterials in Medicine

Background:

  • Limited data exists on drug-coated balloon (DCB) use in acute myocardial infarction (AMI).
  • Percutaneous coronary intervention (PCI) is a standard treatment for AMI.
  • Drug-eluting stents (DES) are commonly used in PCI, but alternatives are being explored.

Purpose of the Study:

  • To evaluate the efficacy and safety of DCB revascularization compared to conventional PCI with second-generation DES in patients with de novo AMI.
  • To assess long-term clinical outcomes, including net adverse cardiovascular events (NACE), target vessel revascularization, and major bleeding.

Main Methods:

  • Retrospective analysis of 329 patients with de novo AMI treated with DCB-based PCI.
  • Propensity score-matched comparison with patients undergoing conventional PCI using DES from a registry.
  • Two-year follow-up to compare NACE rates between the DCB and DES groups.

Main Results:

  • DCB-based PCI showed significantly lower cumulative incidences of NACE (6.2% vs. 10.8%), target vessel revascularization (1.7% vs. 5.7%), and major bleeding (0.8% vs. 3.2%) compared to DES-only PCI after 2 years.
  • These findings were consistent across various statistical adjustment methods, including multivariable regression, propensity score matching, and inverse probability of treatment weighting.
  • DCB-based PCI was independently associated with a reduced risk of 2-year NACE, target vessel revascularization, and major bleeding.

Conclusions:

  • DCB-based PCI demonstrated superior clinical outcomes compared to conventional DES-only PCI in patients with de novo AMI at 2-year follow-up.
  • DCB-based PCI represents a safe and effective alternative for selected AMI patients with optimal pre-dilation.
  • Further prospective studies may confirm these findings and establish DCB as a primary treatment option for de novo AMI.
Abstract

Keywords:
Balloon angioplastyacute myocardial infarctionde novodrug-eluting stentpercutaneous coronary intervention

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