Objective: To evaluate the long-term efficacy of three currently available drug coated balloons (DCB) for the treat-ment of de-novo coronary lesions.

Methods: This was a retrospective analysis of prospectively collected data from the Swedish Coronary Angiogra-phy and Angioplasty Registry. Between 2009 and 2017, three currently available DCB brands used in the treat-ment of de novo lesions were included. Outcomes were clinically driven restenosis and target lesionthrombosis (TLT) (per device) and major adverse cardiac events (MACE) including death, myocardial infarctionor target vessel revascularization (per patient) at 4 years. Multivariable Cox regression models were used to ad-just for differences.

Results: We included 6715 lesions treated with DCBs, 4483 SeQuent® Please (S-DCB), 1071 IN.PACT Falcon (I-DCB) and 1161 Pantera® Lux (P-DCB), in 5670 patients. The mean DCB diameter was 2.4 mm. Bailout stentingoccurred in 6.7% of lesions. Angiographic success was 98.5%. The overall cumulative rate of restenosis was 5.5% (299 events). The risk for reported restenosis did not signifi-cantly differ between I-DCB vs S-DCB, adjusted hazard ratio (aHR) 0.96; 95% confidence interval (CI) 0.69–1.34,P-DCB vs S-DCB aHR 0.88; 95% CI 0.63–1.23 and I-DCB vs P-DCB aHR 1.10; 95% CI 0.72–1.68. The cumulative riskfor TLT was 0.8% in all three DCBs. The risk for MACE or individual components of MACE did not differ betweenthe three patient-groups.

Conclusion:In de novo coronary lesions, we found comparable long-term efficacy with three currently availableDCB brands. DCB angioplasty was feasible with low risk for long-term restenosis and TLT.