Elderly patients with coronary artery disease (CAD) present unique challenges during percutaneous coronary intervention (PCI) due to higher bleeding risk and multiple comorbidities. A prospective analysis, published in the American Journal of Cardiology, compared sirolimus-coated balloons (SCB) with second-generation drug-eluting stents (DES) in patients aged 75 years and older. The study evaluated data from 534 SCB-treated patients in the EASTBOURNE registry and 234 DES-treated patients from the Complex Registry. After cardinality score matching, each group included 220 patients.

At the two-year follow-up, the rates of net adverse cardiovascular events (NACE), which included all-cause death, target lesion revascularization (TLR), non-fatal myocardial infarction (MI), and major bleeding, were similar in both groups (HR 1.28; 95% CI: 0.85–1.93; p=0.239). The incidences of non-fatal MI and TLR showed no significant differences. However, SCB treatment resulted in a significantly lower rate of major bleeding events classified as BARC 3 to 5 compared to DES (HR 0.17; 95% CI: 0.04–0.77; p=0.030).