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Open Access 26-07-2023 | Arterial Diseases | Original Paper

Sex-specific inequalities in the use of drug-coated balloons for small coronary artery disease: a report from the BASKET-SMALL 2 trial

Authors: Maria Rubini Gimenez, Bruno Scheller, Ahmed Farah, Marc-Alexander Ohlow, Norman Mangner, Daniel Weilenmann, Jochen Wöhrle, Florim Cuculi, Gregor Leibundgut, Sven Möbius-Winkler, Marco Cattaneo, Nicole Gilgen, Christoph Kaiser, Raban V. Jeger

Published in: Clinical Research in Cardiology | Issue 7/2024

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Abstract

Background and objectives

Recent data have established non-inferiority of drug-coated balloons (DCB) compared to drug-eluting stents (DES) for treatment of small-vessel coronary artery disease. Since coronary vessels in women might have anatomical and pathophysiological particularities, the safety of the DCB strategy among women compared to men needs to be assessed in more detail.

Methods

In BASKET-SMALL 2, patients with de novo lesions in coronary vessels < 3 mm and an indication for percutaneous coronary intervention were randomly allocated (1:1) to DCB vs. DES after successful lesion preparation. The primary objective of the randomized trial was to establish non-inferiority of DCB vs. DES regarding major adverse cardiac events (MACE; i.e., cardiac death, non-fatal myocardial infarction, and target vessel revascularization) after 12 months. The aim of the current sub-analysis is to evaluate whether the DCB strategy is equally safe among women and men after 12 and 36 months.

Results

Among 758 randomized patients, 382 were assigned to DCB (23% women) and 376 to DES (30% women). In general, women were older, had more often diabetes mellitus and renal insufficiency, and presented more often with an acute coronary syndrome, whereas men were more often smokers, had multivessel disease and a previous history of acute myocardial infarction, and received a treatment with a statin. After 3 years, the primary clinical end point was not significantly different between groups (13% women vs. 16% men, HR 0.82; 95% CI 0.52−1.30; p = 0.40). There was no interaction between sex and coronary intervention strategy regarding MACE at 36 months (10% women vs. 16% men in DCB, 16% women vs. 15% men in DES; pinteraction = 0.31).

Conclusion

In small native coronary artery disease, there was no statistically significant effect of sex on the difference between DCB and DES regarding MACE up to 36 months.

Clinical trial registration

URL: http://​www.​clinicaltrials.​gov. Unique identifier: NCT01574534.

Graphical abstract

Appendix
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Metadata
Title
Sex-specific inequalities in the use of drug-coated balloons for small coronary artery disease: a report from the BASKET-SMALL 2 trial
Authors
Maria Rubini Gimenez
Bruno Scheller
Ahmed Farah
Marc-Alexander Ohlow
Norman Mangner
Daniel Weilenmann
Jochen Wöhrle
Florim Cuculi
Gregor Leibundgut
Sven Möbius-Winkler
Marco Cattaneo
Nicole Gilgen
Christoph Kaiser
Raban V. Jeger
Publication date
26-07-2023
Publisher
Springer Berlin Heidelberg
Published in
Clinical Research in Cardiology / Issue 7/2024
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-023-02249-6

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