Impact of Drug‐Coated Balloon Inflation Time on Outcome After Percutaneous Coronary Intervention: An Observational Study From SCAAR

Background There are limited data guiding the optimal inflation time for coronary drug‐coated balloons. The aim of this study was to assess the clinical efficacy of an inflation time of ≥30 seconds compared with <30 seconds. Methods We conducted an observational nationwide analysis using the SCAAR (Swedish Coronary Angiography and Angioplasty Registry) to identify all patients undergoing percutaneous coronary intervention with drug‐coated balloons and their inflation times. Outcomes were assessed at 1 year using Kaplan–Meier estimates and adjusted Cox regression. Results The <30‐second group comprised 412 patients, and the ≥30‐second group 10 826 patients. Patients in the <30‐second group presented more often with lesions in proximal segments. After a 1‐year follow‐up, ≥30 seconds was associated with lower rates of target segment revascularization compared with <30 seconds (3.2% versus 6.4%, adjusted hazard ratio [HR], 0.47 [95% CI, 0.32–0.69], P ≤0.001) and target vessel myocardial infarction (1.8% versus 5.3%, adjusted HR, 0.32 [95% CI, 0.21–0.50], P ≤0.001). No difference was observed for all‐cause mortality. Conclusions In this analysis, including 11 238 patients undergoing PCI with drug‐coated balloons, ≥30 second inflation time was associated with improved outcomes compared with a shorter inflation time.