Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://cr.elmerpub.com

Short Communication

Volume 17, Number 5, October 2026, pages 545-551

Regional Differences Between Drug-Coated Balloons and Drug-Eluting Stents in De Novo Coronary Disease

Figures

↓ Figure 1. PRISMA 2020 flow diagram of study identification, screening, and inclusion. Records were identified from PubMed (n = 254), Embase (n = 611), and Cochrane Central (n = 295); after removal of 409 duplicates, 751 records were screened, of which 706 were excluded at title and abstract review. Forty-five reports underwent full-text review (clinical outcomes not reported, n = 2; inclusion criteria not met, n = 4; overlapping population, n = 16; narrative review, n = 1; excluded studies are listed (Supplementary Material 5, cr.elmerpub.com), yielding 13 randomized controlled trials reported across 21 publications. PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; RCT: randomized controlled trial.

↓ Figure 2. Random-effects forest plot of the device-oriented composite outcome (DOCO), with trials stratified by continent of enrollment (pre-specified subgroup, PROSPERO CRD420251178732). Overall IRR = 1.00 (95% CI, 0.70–1.44), I² = 49.1%; Europe 0.83 (0.44–1.57); Asia 1.48 (1.04–2.11); test for subgroup differences χ² = 4.16, df = 1, P = 0.04, k = 12. DCB: drug-coated balloon; DES: drug-eluting stent; CI: confidence interval; IRR: incidence rate ratio.

Table

↓ **Table 1.** Pooled incidence rate ratios for DCB versus DES, overall and by region
Outcome	k	Events DCB/DES	Overall IRR (95% CI)	I²	Europe IRR (95% CI)	Asia IRR (95% CI)	Subgroup P
Random-effects (DerSimonian-Laird τ²) IRRs with Hartung-Knapp 95% CIs; IRR > 1 favors DES. k: number of trials contributing; DOCO: device-oriented composite outcome; TLR: target-lesion revascularization; TV: target-vessel; DCB: drug-coated balloon; DES: drug-eluting stent; CI: confidence interval; IRR: incidence rate ratio.
DOCO (primary)	12	210/190	1.00 (0.70–1.44)	49.1%	0.83 (0.44–1.57)	1.48 (1.04–2.11)	0.04
TLR	11	94/65	1.24 (0.72–2.14)	46.3%	0.94 (0.23–3.86)	2.03 (1.19–3.44)	0.12
All-cause mortality	9	89/81	1.10 (0.92–1.31)	0%	0.94 (0.60–1.48)	1.23 (1.12–1.36)	0.07
Cardiac death	11	57/47	1.20 (0.94–1.52)	0%	1.37 (0.95–1.98)	1.11 (0.71–1.75)	0.33
Myocardial infarction	12	59/75	0.80 (0.62–1.03)	0%	0.69 (0.41–1.16)	0.93 (0.73–1.17)	0.19
TV / stent thrombosis	11	6/14	0.64 (0.37–1.10)	0%	0.37 (0.13–1.02)	1.03 (0.64–1.65)	0.01