EFFECTIVENESS OF DRUG-COATED BALLOONS FOR ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION: A META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS AND IMPLICATIONS FOR CARDIAC REHABILITATION AND PHYSICAL ACTIVITY

Abstract

Objective: This meta-analysis aimed to evaluate the safety and efficacy of drug-coated balloons (DCBs) in managing ST-segment elevation myocardial infarction (STEMI) in patients undergoing emergency coronary intervention, with a focus on long-term cardiac outcomes relevant to cardiac rehabilitation and physical activity. Methods: A comprehensive literature search was conducted in databases including China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Data, VIP Database, PubMed, the Cochrane Library, Web of Science, and EMBASE, covering randomized controlled trials comparing DCBs with drug-eluting stents (DES) for STEMI treatment up to May 1, 2024. Data were analyzed using RevMan 5.3 software to compare cardiovascular mortality, reinfarction, target lesion revascularization (TLR), major adverse cardiovascular events (MACEs), and late lumen loss (LLL) between the two groups. Results: Six studies involving 780 patients were included, with 387 in the DCB group and 393 in the DES group. No statistically significant differences were observed in cardiovascular mortality (odds ratio [OR] = 0.66, 95% confidence interval [CI] = 0.17–2.55, P = 0.54), reinfarction rates (OR = 1.11, 95% CI = 0.44–2.77, P = 0.83), TLR (OR = 0.54, 95% CI = 0.23–1.29, P = 0.16), or MACEs (OR = 0.52, 95% CI = 0.26–1.07, P = 0.07). However, DCBs significantly reduced late lumen loss in the target lesion (mean difference = −0.16, 95% CI = −0.25 to −0.08, P < 0.01), indicating improved vessel healing and reduced restenosis risk. Conclusion: DCBs demonstrated comparable efficacy to DES in the emergency treatment of STEMI while offering a significant reduction in late lumen loss. These findings highlight DCBs as a viable alternative for STEMI management, with potential implications for improving long-term outcomes in cardiac rehabilitation. Incorporating DCB-based treatments into post-STEMI recovery protocols may enhance physical activity tolerance, reduce cardiovascular risks, and support better overall cardiac health in sports and rehabilitation settings.