Research comparing paclitaxel and sirolimus-coated balloons (PCB and SCB), used in coronary artery disease (CAD) treatment, finds similar outcomes between the two balloons with respect to MACE at 2-years follow-up. Presenting on Thursday during a Late-Breaking Trial session at the EuroPCR Congress 2025 in Paris, lead investigator Bernardo Cortese, MD, of the University Hospitals Harrington Heart & Vascular Institute in Cleveland, Ohio, revealed no statistically significant differences between the two groups. “The rate of major adverse cardiac events (MACE), which included all-cause mortality, myocardial infarction (MI), and target-lesion revascularization (TLR), was similar (Hazard Ratio [HR], 0.80; 95% confidence Interval [CI]: 0.59–1.11, p= 0.181),” noted Dr Cortese. Secondary outcomes However, further findings, particularly with secondary outcomes, revealed notable contrasts. “The SCB group experienced a higher rate of all-cause mortality (HR, 3.32; 95% CI: 1.53–7.24, p= 0.002)” while showing “a lower rate of TLR (HR, 0.64; 95% CI: 0.42–0.96, p = 0.031),” noted Dr. Cortese. There was “no significant difference in the MI rate (HR, 0.64; 95% CI: 0.34–1.18, p = 0.153),” he added. The data offer important insights for the optimal use of these two types of drug-coated balloons (DCBs). While PCBs have been the most employed DCB in clinical practice, concerns about their safety have prompted interest in sirolimus-coated alternatives. Limited data Discussing the findings, Dr. Cortese acknowledged that real-world comparisons of the clinical outcomes of PCB and SCB remained limited. He also emphasized that the analysis contributed vital comparative evidence to the field with subgroup results showing consistency with the study’s overall findings. The findings pointed to both types of DCBs offering viable alternatives to drug-eluting stents for selected patients with CAD, with findings for the secondary outcomes meriting further investigation. Methodology The study looked at 2,591 patients from two prospective registries: EASTBOURNE (SCB, n=2078) and PEARL (PCB, n=513). After matching based on age, sex, diabetes, prior CAD and CAD complexity, 513 patients per group were compared. The study population was 80.1% male and 19.9% female. The primary outcome was MACE, defined as a composite of all-cause mortality, MI and TLR at two-year follow-up. Image Credit: Health Studio – stock.adobe.com