[Comparison of clinical outcomes of DCB angioplasty versus DES implantation in patients with recently diagnosed cancer and coronary artery disease undergoing PCI].
Among patients with recently diagnosed cancer and concomitant CAD undergoing PCI, DCB angioplasty was associated with lower overall survival than DES implantation, without a significant increase in cardiovascular mortality, with the survival difference mainly related to higher cumulative incidence of non-cardiovascular death.
Key Findings
Results
Overall survival was significantly lower in the DCB group than in the DES group among cancer patients undergoing PCI.
Kaplan-Meier analysis showed overall survival of 82.0% (50/61) in the DCB group versus 95.7% (90/94) in the DES group.
The difference was statistically significant (P=0.005) by Log-rank test.
Study enrolled 155 patients from January 2018 to December 2024 at Beijing Chaoyang Hospital, Capital Medical University.
All patients had been diagnosed with cancer within 5 years prior to admission and underwent PCI confirmed by coronary angiography.
Results
The cumulative incidence of cardiovascular death did not differ significantly between the DCB and DES groups.
Cardiovascular death occurred in 4.9% (3/61) of the DCB group and 3.2% (3/94) of the DES group.
Gray's test showed no statistically significant difference (P=0.589).
Cardiovascular and non-cardiovascular deaths were treated as competing events and analyzed using cumulative incidence function and Gray's test.
Results
The cumulative incidence of non-cardiovascular death was significantly higher in the DCB group than in the DES group.
Non-cardiovascular death occurred in 13.1% (8/61) of the DCB group versus 1.1% (1/94) of the DES group.
The difference was statistically significant (P=0.002) by Gray's test.
This non-cardiovascular mortality difference was identified as the main driver of the overall survival gap between groups.
Results
The DCB and DES groups differed significantly in several baseline clinical and lesion characteristics.
The DCB group had higher proportions of diabetes mellitus, triple-vessel disease, in-stent restenosis, bifurcation lesions, and small-vessel disease (all P<0.05).
The DES group had higher proportions of previous PCI, previous coronary artery bypass grafting (CABG), and left anterior descending artery interventions (all P<0.05).
No significant between-group differences were observed in age, sex, BMI, current smoking, dyslipidemia, hypertension, previous myocardial infarction, or chronic kidney disease (all P>0.05).
DCB group: n=61; DES group: n=94.
Methods
The study was a retrospective single-center analysis of cancer patients with concomitant coronary artery disease who underwent PCI.
155 patients were retrospectively enrolled from the Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, from January 2018 to December 2024.
Inclusion required definitive CAD diagnosis via coronary angiography, PCI treatment, and a cancer diagnosis within 5 years prior to the current admission.
Continuous normally distributed variables were compared using independent-samples t-test; categorical variables were compared using Pearson's χ² test or Fisher's exact test.
Overall survival was estimated using the Kaplan-Meier method with Log-rank test; competing risk analysis used cumulative incidence function and Gray's test.
What This Means
This research examined outcomes for cancer patients who also needed a heart procedure called percutaneous coronary intervention (PCI), comparing two approaches: drug-coated balloon (DCB) angioplasty and drug-eluting stent (DES) implantation. The study looked at 155 patients treated at a Chinese hospital between 2018 and 2024, all of whom had been diagnosed with cancer within the past five years and had coronary artery disease requiring PCI. The researchers found that patients treated with DCBs had significantly lower overall survival (82%) compared to those treated with DESs (95.7%).
Importantly, when the researchers examined the causes of death separately, they found no significant difference in deaths due to heart-related causes between the two groups (about 5% for DCB vs. 3% for DES). However, deaths from non-cardiovascular causes—most likely cancer progression or cancer-related complications—were much higher in the DCB group (13.1%) compared to the DES group (1.1%). The DCB group also had more complex coronary disease at the outset, including more patients with diabetes, triple-vessel disease, and difficult lesion types, which may have influenced treatment selection and outcomes.
This research suggests that while DCB angioplasty does not appear to increase the risk of dying from heart disease in this high-risk population, patients treated with DCBs had notably higher rates of non-cardiac death, which drove the overall survival difference. The authors conclude that further studies are needed to better understand the long-term safety of DCB angioplasty in patients who have both cancer and coronary artery disease, particularly because baseline differences between the two groups make direct comparison challenging.
Li X, Tan Y, Li H. (2026). [Comparison of clinical outcomes of DCB angioplasty versus DES implantation in patients with recently diagnosed cancer and coronary artery disease undergoing PCI].. Zhonghua yi xue za zhi. https://doi.org/10.3760/cma.j.cn112137-20260430-01184