Sirolimus-coated balloon in young versus old patients with coronary artery disease: a sub-analysis of the EASTBOURNE study

To the Editor, Premature coronary artery disease (CAD) affects 7%-10% of patients younger than 55 years, leading to reduced quality of life and a significant risk of adverse events.1 Percutaneous coronary intervention (PCI) with drug-eluting stents (DES), the standard treatment for this populations, is associated with a 7.3% rate of failure at the 3-year follow-up.2 The use of drug-coated balloons (DCB) eliminates the need for permanent stent strut deployment, offering potential advantages to patients with premature CAD.3 However, the clinical efficacy of DCB angioplasty in premature CAD remains underexplored. The aim of this study was to compare the efficacy of DCB angioplasty in patients aged < 55 and ≥ 55 years undergoing PCI with sirolimus-coated balloon (SCB). EASTBOURNE (ClinicalTrials.gov: NCT03085823) is a prospective, multicenter, investigator-initiated study that included consecutive patients who underwent PCI with the MagicTouch SCB (Concept Medical, United States) at 38 European and Asian centers from 2016 through 2020. Exclusion criteria were unsuccessful target lesion predilation with persistent residual percent diameter stenosis > 50%, highly tortuous target vessel, severe target vessel calcifications, and high thrombus burden in the target lesion, not amenable to treatment with manual aspiration.4 PCI was performed following the recommendations of the DCB Consensus Group.3 The primary endpoint was...