Covid-19 Research

Perspective

Harnessing Nutrition to Prevent Coronary Recoil in Drug-Coated Balloon Angioplasty: Insights from Bethsaida Hospital

Journal of Biomedical Research & Environmental Sciences article abstract with citation details, DOI, publication dates, subject areas, full text links, and references.

View DOI Submit Manuscript

Article Details

Publication record, authors, dates, abstract, and full text access.

Open Access
Article Type Perspective
Subject Medicine Group
OCLC JBRES Record
Dasaad Mulijono*
Issue: Volume6-Issue8
Pages: 1026-1032
Received: 2025-06-26
Accepted: 2025-08-10
Published: 2025-08-11

Abstract

The success of Drug-Coated Balloon (DCB) angioplasty hinges critically on effectively preventing coronary artery recoil, an acute elastic response that threatens procedural efficacy and long-term vessel patency. While technical approaches remain foundational, emerging evidence reveals dietary intervention as a pivotal, yet significantly undervalued strategy. At Bethsaida Hospital, under the visionary leadership of Prof. Dasaad Mulijono, implementing a whole-food, plant-based dietary regimen before DCB procedures has profoundly decreased acute recoil incidence. Remarkably, this dietary approach has yielded a restenosis rate of only 2%, marking one of the lowest recorded outcomes in Indonesia. Such compelling data underscore the potential of dietary modification, particularly emphasizing foods rich in Nitric Oxide (NO) precursors and antioxidants, as a potentially revolutionary adjunctive therapy in interventional cardiology. Given these provocative findings, further rigorous investigations are urgently required to confirm the robustness and broad applicability of these transformative dietary interventions.

FullText HTML FullText PDF DOI: 10.37871/jbres2158 Crossmark

Certificate of Publication

Certificate of Publication

Copyright

© 2025 Mulijono D, Distributed under Creative Commons CC-BY 4.0 Creative CommonsAttribution

How to cite this article

Mulijono D. Harnessing Nutrition to Prevent Coronary Recoil in Drug-Coated Balloon Angioplasty: Insights from Bethsaida Hospital. J Biomed Res Environ Sci. 2025 Aug 11; 6(8): 1026-1032. doi: 10.37871/jbres2158, Article ID: JBRES2158, Available at: https://www.jelsciences.com/articles/jbres2158.pdf

Subject area(s)

TherapeuticsNutritionCardiovascular DiseasesClinical Cardiology

References

  1. Muramatsu T, Kozuma K, Tanabe K, Morino Y, Ako J, Nakamura S, Yamaji K, Kohsaka S, Amano T, Kobayashi Y, Ikari Y, Kadota K, Nakamura M; Task Force of the Japanese Association of Cardiovascular Intervention, Therapeutics (CVIT). Clinical expert consensus document on drug-coated balloon for coronary artery disease from the Japanese Association of Cardiovascular Intervention and Therapeutics. Cardiovasc Interv Ther. 2023 Apr;38(2):166-176. doi: 10.1007/s12928-023-00921-2. Epub 2023 Feb 27. PMID: 36847902; PMCID: PMC10020262.
  2. Korjian S, McCarthy KJ, Larnard EA, Cutlip DE, McEntegart MB, Kirtane AJ, Yeh RW. Drug-Coated Balloons in the Management of Coronary Artery Disease. Circ Cardiovasc Interv. 2024 May;17(5):e013302. doi: 10.1161/CIRCINTERVENTIONS.123.013302. Epub 2024 May 21. PMID: 38771909..
  3. Lazar FL, Onea HL, Olinic DM, Cortese B. A 2024 scientific update on the clinical performance of drug-coated balloons. AsiaIntervention. 2024 Feb 29;10(1):15-25. doi: 10.4244/AIJ-D-23-00010. PMID: 38425817; PMCID: PMC10900242.
  4. Camaj A, Leone PP, Colombo A, Vinayak M, Stone GW, Mehran R, Dangas G, Kini A, Sharma SK. Drug-Coated Balloons for the Treatment of Coronary Artery Disease: A Review. JAMA Cardiol. 2025 Feb 1;10(2):189-198. doi: 10.1001/jamacardio.2024.4244. PMID: 39714903.
  5. Expert Writing Committee of the Chinese Expert Consensus on Clinical Applications of Drug-Coated Balloon (2nd Edition); Ge JB, Chen YD. Chinese expert consensus on the clinical application of drug-coated balloon (2nd Edition). J Geriatr Cardiol. 2024 Feb 28;21(2):135-152. doi: 10.26599/1671-5411.2024.02.001. PMID: 38544494; PMCID: PMC10964015.
  6. Wang L, Li X, Li T, Liu L, Wang H, Wang C. Novel application of drug-coated balloons in coronary heart disease: A narrative review. Front Cardiovasc Med. 2023 Mar 2;10:1055274. doi: 10.3389/fcvm.2023.1055274. PMID: 36937937; PMCID: PMC10017483.
  7. Kundu A, Moliterno DJ. Drug-Coated Balloons for In-Stent Restenosis-Finally Leaving Nothing Behind for US Patients. JAMA. 2024 Mar 26;331(12):1011-1012. doi: 10.1001/jama.2024.0813. PMID: 38460158.
  8. Tervo J, Kärkkäinen JM, Rissanen TT. Technical success, clinical efficacy, and insight into the causes of restenosis after the percutaneous coronary intervention of de novo coronary artery lesions using a paclitaxel-coated balloon with citrate ester excipient. Front Cardiovasc Med. 2022 Oct 31;9:1012473. doi: 10.3389/fcvm.2022.1012473. PMID: 36386336; PMCID: PMC9662788.
  9. Yamamoto T, Ishii T, Ishida A. Impact of post physiological assessment after treatment for de novo coronary lesions using drug-coated balloons. Int J Cardiol. 2022 Sep 15;363:11-19. doi: 10.1016/j.ijcard.2022.06.009. Epub 2022 Jun 6. PMID: 35680055.
  10. Marchetta M, Sasso S, Paragliola V, Maffi V, Chiricolo G, Massaro G, Russo G, Benedetto D, Muscoli S, Colonna G, Mandurino-Mirizzi A, Cortese B, Sangiorgi GM, Andò G. Leaving Nothing Behind: Expanding the Clinical Frontiers of Drug-Coated Balloon Angioplasty in Coronary Artery Disease. J Cardiovasc Dev Dis. 2025 May 5;12(5):176. doi: 10.3390/jcdd12050176. PMID: 40422946; PMCID: PMC12112498.
  11. Rafieian-Kopaei M, Setorki M, Doudi M, Baradaran A, Nasri H. Atherosclerosis: process, indicators, risk factors and new hopes. Int J Prev Med. 2014 Aug;5(8):927-46. PMID: 25489440; PMCID: PMC4258672.
  12. Gusev E, Sarapultsev A. Atherosclerosis and Inflammation: Insights from the Theory of General Pathological Processes. Int J Mol Sci. 2023 Apr 26;24(9):7910. doi: 10.3390/ijms24097910. PMID: 37175617; PMCID: PMC10178362.
  13. Ornish D, Scherwitz LW, Billings JH, Brown SE, Gould KL, Merritt TA, Sparler S, Armstrong WT, Ports TA, Kirkeeide RL, Hogeboom C, Brand RJ. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998 Dec 16;280(23):2001-7. doi: 10.1001/jama.280.23.2001. Erratum in: JAMA 1999 Apr 21;281(15):1380. PMID: 9863851.
  14. Esselstyn CB Jr, Gendy G, Doyle J, Golubic M, Roizen MF. A way to reverse CAD? J Fam Pract. 2014 Jul;63(7):356-364b. PMID: 25198208.
  15. Tuso P, Stoll SR, Li WW. A plant-based diet, atherogenesis, and coronary artery disease prevention. Perm J. 2015 Winter;19(1):62-7. doi: 10.7812/TPP/14-036. Epub 2014 Nov 24. PMID: 25431999; PMCID: PMC4315380.
  16. Mehta P, Tawfeeq S, Padte S, Sunasra R, Desai H, Surani S, Kashyap R. Plant-based diet and its effect on coronary artery disease: A narrative review. World J Clin Cases. 2023 Jul 16;11(20):4752-4762. doi: 10.12998/wjcc.v11.i20.4752. PMID: 37583985; PMCID: PMC10424050.
  17. Peña-Jorquera H, Cid-Jofré V, Landaeta-Díaz L, Petermann-Rocha F, Martorell M, Zbinden-Foncea H, Ferrari G, Jorquera-Aguilera C, Cristi-Montero C. Plant-Based Nutrition: Exploring Health Benefits for Atherosclerosis, Chronic Diseases, and Metabolic Syndrome-A Comprehensive Review. Nutrients. 2023 Jul 21;15(14):3244. doi: 10.3390/nu15143244. PMID: 37513660; PMCID: PMC10386413.
  18. Salehin S, Rasmussen P, Mai S, Mushtaq M, Agarwal M, Hasan SM, Salehin S, Raja M, Gilani S, Khalife WI. Plant Based Diet and Its Effect on Cardiovascular Disease. Int J Environ Res Public Health. 2023 Feb 14;20(4):3337. doi: 10.3390/ijerph20043337. PMID: 36834032; PMCID: PMC9963093.
  19. Shin ES, Ann SH, Jang MH, Kim B, Kim TH, Sohn CB, Choi BJ. Impact of Scoring Balloon Angioplasty on Lesion Preparation for DCB Treatment of Coronary Lesions. J Clin Med. 2023 Sep 28;12(19):6254. doi: 10.3390/jcm12196254. PMID: 37834898; PMCID: PMC10573989.
  20. Bonaventura K, Schwefer M, Yusof AKM, Waliszewski M, Krackhardt F, Steen P, Ocaranza R, Zuhdi AS, Bang LH, Graf K, Böck U, Chin K. Systematic Scoring Balloon Lesion Preparation for Drug-Coated Balloon Angioplasty in Clinical Routine: Results of the PASSWORD Observational Study. Adv Ther. 2020 May;37(5):2210-2223. doi: 10.1007/s12325-020-01320-2. Epub 2020 Apr 9. PMID: 32274746; PMCID: PMC7467461.
  21. Uskela S, Eranti A, Kärkkäinen JM, Rissanen TT. Drug-coated balloon-only strategy for percutaneous coronary intervention of de novo left main coronary artery disease: the importance of proper lesion preparation. Front Med. 2023 Feb;17(1):75-84. doi: 10.1007/s11684-022-0950-1. Epub 2022 Dec 23. PMID: 36562952.
  22. Ueno K, Morita N, Kojima Y, Kondo H, Takahashi H, Minatoguchi S, Higuchi S, Ando Y, Esaki M. Efficacy of Low-Pressure Inflation of Oversized Drug-Coated Balloon for Coronary Artery Disease. J Interv Cardiol. 2020 Dec 27;2020:6615988. doi: 10.1155/2020/6615988. PMID: 33447166; PMCID: PMC7781681.
  23. Arslani K, Jeger R. Drug-coated Balloons for Small Coronary Disease-A Literature Review. Curr Cardiol Rep. 2021 Oct 14;23(11):173. doi: 10.1007/s11886-021-01586-0. PMID: 34648080; PMCID: PMC8516758.
  24. Shin D, Singh M, Shlofmitz E, Scheller B, Latib A, Kandzari DE, Zaman A, Mylotte D, Dakroub A, Malik S, Sakai K, Jeremias A, Moses JW, Shlofmitz RA, Stone GW, Ali ZA. Paclitaxel-coated versus sirolimus-coated balloon angioplasty for coronary artery disease: A systematic review and meta-analysis. Catheter Cardiovasc Interv. 2024 Sep;104(3):425-436. doi: 10.1002/ccd.31154. Epub 2024 Jul 24. PMID: 39044661.
  25. Cortese B, Caiazzo G, Di Palma G, De Rosa S. Comparison Between Sirolimus- and Paclitaxel-Coated Balloon for Revascularization of Coronary Arteries: The SIRPAC (SIRolimus-PAClitaxel) Study. Cardiovasc Revasc Med. 2021 Jul;28:1-6. doi: 10.1016/j.carrev.2021.04.013. Epub 2021 Apr 17. PMID: 33888418; PMCID: PMC8373518.
  26. Zhou Y, Hu Y, Zhao X, Chen Z, Li C, Ma L, Liu Z, Zhou H, Zang X, Zhang X, Zhang G, Cui Z, Liu Y, Han S, Wu L, Shi H, Jiang J, Qian J, Lu H, Ge J. Sirolimus-coated versus paclitaxel-coated balloons for bifurcated coronary lesions in the side branch: the SPACIOUS trial. EuroIntervention. 2025 Mar 17;21(6):e307-e317. doi: 10.4244/EIJ-D-24-00742. PMID: 40091874; PMCID: PMC11891925.
  27. Scheller B, Mangner N, Jeger RV, Afan S, Mahfoud F, Woitek FJ, Fahrni G, Schwenke C, Schnorr B, Kleber F. A randomised trial of sirolimus- versus paclitaxel-coated balloons for de novo coronary lesions. EuroIntervention. 2024 Nov 4;20(21):e1322-e1329. doi: 10.4244/EIJ-D-23-00868. PMID: 39492703; PMCID: PMC11522860.
  28. Liu Y, Zhang B, Lv H, Zhu Y, Zhou X, Zhu H, Guo L. Drug-Coated Balloon for de-novo Coronary Artery Lesions Exceeding 2.5 mm in Diameter: Optical Coherence Tomography Analysis and Clinical Follow-Up. Int J Gen Med. 2024 Jan 22;17:225-236. doi: 10.2147/IJGM.S451329. PMID: 38283074; PMCID: PMC10812136.
  29. Gao XF, Ge Z, Kong XQ, Chen X, Han L, Qian XS, Zuo GF, Wang ZM, Wang J, Song JX, Lin L, Pan T, Ye F, Wang Y, Zhang JJ, Chen SL; ULTIMATE â…¢ Investigators. Intravascular Ultrasound vs Angiography-Guided Drug-Coated Balloon Angioplasty: The ULTIMATE â…¢ Trial. JACC Cardiovasc Interv. 2024 Jul 8;17(13):1519-1528. doi: 10.1016/j.jcin.2024.04.014. Epub 2024 Jun 5. PMID: 38842991.
  30. Alfonso F, Kundu A. Intracoronary Imaging to Guide Drug-Coated Balloon Angioplasty: Ready for Primetime? JACC Cardiovasc Interv. 2024 Jul 8;17(13):1529-1532. doi: 10.1016/j.jcin.2024.04.024. Epub 2024 Jun 5. PMID: 38842996.
  31. Alfonso F, Cortese B. Is intravascular ultrasound needed to optimize drug-coated balloon angioplasty results? Eur Heart J. 2024 Nov 8;45(42):4542-4543. doi: 10.1093/eurheartj/ehae621. PMID: 39319641.
  32. Kawai T, Watanabe T, Yamada T, Morita T, Furukawa Y, Tamaki S, Kawasaki M, Kikuchi A, Seo M, Nakamura J, Tachibana K, Kida H, Sotomi Y, Sakata Y, Fukunami M. Coronary vasomotion after treatment with drug-coated balloons or drug-eluting stents: a prospective, open-label, single-centre randomised trial. EuroIntervention. 2022 Jun 3;18(2):e140-e148. doi: 10.4244/EIJ-D-21-00636. PMID: 34757917; PMCID: PMC9904379.
  33. Arita Y, Fukui T, Ogasawara N. Slow-flow phenomenon after drug-coated balloon angioplasty for lower-extremity arteries is associated with lack of prescribing of calcium channel blockers. Indian Heart J. 2023 Jan-Feb;75(1):82-85. doi: 10.1016/j.ihj.2023.01.005. Epub 2023 Jan 10. PMID: 36638886; PMCID: PMC9986730.
  34. Her AY, Kim B, Ahn SH, Park Y, Cho JR, Jeong YH, Shin ES. Long-Term Clinical Outcomes of Drug-Coated Balloon Treatment for De Novo Coronary Lesions. Yonsei Med J. 2023 Jun;64(6):359-365. doi: 10.3349/ymj.2022.0633. PMID: 37226562; PMCID: PMC10232998.
  35. Basavarajaiah S, Kalkat H, Bhatia G, Cortese B. How to perform a successful drug-coated balloon angioplasty? Tips and tricks. Catheter Cardiovasc Interv. 2023 Dec;102(7):1238-1257. doi: 10.1002/ccd.30851. Epub 2023 Nov 10. PMID: 37948409.
  36. Mullasari SA, Subban V. Drug-coated balloons - a promising technology that needs more understanding! AsiaIntervention. 2025 Mar 20;11(1):12-13. doi: 10.4244/AIJ-E-25-00001. PMID: 40114737; PMCID: PMC11905107.
  37. Kim S, Kang DO, Her AY, Song WH, Shin ES. Drug-coated balloon-based percutaneous coronary intervention in de novo coronary artery disease and tips for procedural success. J Cardiovasc Interv. 2024;3(4):190-198.
  38. Her AY, Shin ES, Bang LH, Nuruddin AA, Tang Q, Hsieh IC, Hsu JC, Kiam OT, Qiu C, Qian J, Ahmad WAW, Ali RM. Drug-coated balloon treatment in coronary artery disease: Recommendations from an Asia-Pacific Consensus Group. Cardiol J. 2021;28(1):136-149. doi: 10.5603/CJ.a2019.0093. Epub 2019 Sep 30. PMID: 31565793; PMCID: PMC8105061.
  39. Rosenberg M, Waliszewski M, Krackhardt F, Chin K, Wan Ahmad WA, Caramanno G, Milazzo D, Nuruddin AA, Liew HB, Maskon O, Bento A, Macia JC, Frey N. Drug Coated Balloon-Only Strategy in De Novo Lesions of Large Coronary Vessels. J Interv Cardiol. 2019 Feb 3;2019:6548696. doi: 10.1155/2019/6548696. PMID: 31772539; PMCID: PMC6739788.
  40. Sato Y, Kuntz SH, Surve D, Jinnouchi H, Sakamoto A, Cornelissen A, Virmani R, Kolodgie F, Finn AV. What are the Pathological Concerns and Limitations of Current Drug-coated Balloon Technology? Heart Int. 2019 Oct 11;13(1):15-22. doi: 10.17925/HI.2019.13.1.15. PMID: 36275500; PMCID: PMC9524611.
  41. Florek K, Bartoszewska E, Biegała S, Klimek O, Malcharczyk B, Kübler P. Rotational Atherectomy, Orbital Atherectomy, and Intravascular Lithotripsy Comparison for Calcified Coronary Lesions. J Clin Med. 2023 Nov 23;12(23):7246. doi: 10.3390/jcm12237246. PMID: 38068298; PMCID: PMC10707420.
  42. Allan M, Vickers D, Pitney M, Jepson N. Rotational Atherectomy Combined with Drug Coated-Balloons for in-Stent Restenosis. Cardiovasc Revasc Med. 2019 Jul;20(7):559-562. doi: 10.1016/j.carrev.2018.08.019. Epub 2018 Aug 25. PMID: 30217627.
  43. Umeh CA, Kaur H, Paknoosh S, Ganjian B, Samreen I, Rainee K, Cheng M, Rastogi A, Gupta R. Intravascular lithotripsy in coronary arteries: a review of case reports. Egypt Heart J. 2024 Sep 7;76(1):121. doi: 10.1186/s43044-024-00555-6. PMID: 39243292; PMCID: PMC11380655.
  44. Mitsui K, Lee T, Miyazaki R, Hara N, Nagamine S, Nakamura T, Terui M, Okata S, Nagase M, Nitta G, Watanabe K, Kaneko M, Nagata Y, Nozato T, Ashikaga T. Drug-coated balloon strategy following orbital atherectomy for calcified coronary artery compared with drug-eluting stent: One-year outcomes and optical coherence tomography assessment. Catheter Cardiovasc Interv. 2023 Jul;102(1):11-17. doi: 10.1002/ccd.30689. Epub 2023 May 20. PMID: 37210618.
  45. Zhao Y, Wang P, Zheng Z, Shi Y, Liu J. Comparison of intravascular lithotripsy versus rotational atherectomy for the treatment of severe coronary artery calcification. BMC Cardiovasc Disord. 2024 Jun 19;24(1):311. doi: 10.1186/s12872-024-03965-1. PMID: 38898393; PMCID: PMC11186212.
  46. Corballis NH, Wickramarachchi U, Vassiliou VS, Eccleshall SC. Duration of dual antiplatelet therapy in elective drug-coated balloon angioplasty. Catheter Cardiovasc Interv. 2020 Nov;96(5):1016-1020. doi: 10.1002/ccd.28632. Epub 2019 Dec 4. PMID: 31797532.
  47. Zhang Y, Zhang X, Dong Q, Chen D, Xu Y, Jiang J. Duration of Dual Antiplatelet Therapy After Implantation of Drug-Coated Balloon. Front Cardiovasc Med. 2021 Dec 1;8:762391. doi: 10.3389/fcvm.2021.762391. PMID: 34926613; PMCID: PMC8671702.
  48. Gao C, Zhu B, Ouyang F, Wen S, Xu Y, Jia W, Yang P, He Y, Zhong Y, Zhou Y, Guo Z, Shen G, Ma L, Xu L, Xue Y, Hu T, Wang Q, Liu Y, Zhang R, Liu J, Jiang Z, Xia J, Garg S, van Geuns RJ, Capodanno D, Onuma Y, Wang D, Serruys P, Tao L; REC-CAGEFREE II Investigators. Stepwise dual antiplatelet therapy de-escalation in patients after drug coated balloon angioplasty (REC-CAGEFREE II): multicentre, randomised, open label, assessor blind, non-inferiority trial. BMJ. 2025 Mar 31;388:e082945. doi: 10.1136/bmj-2024-082945. Erratum in: BMJ. 2025 Apr 8;389:r694. doi: 10.1136/bmj.r694. PMID: 40164448; PMCID: PMC11955879.
  49. Chlan L. Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance. Heart Lung. 1998 May-Jun;27(3):169-76. doi: 10.1016/s0147-9563(98)90004-8. PMID: 9622403.
  50. Bensimon M, Shaul S, Div S, Sandler L, Teitelbaum A. Patient-centered Approach in Closed Psychiatric Wards: The Curative Power of Relaxing Music Chosen by Patients. Isr J Psychiatry. 2018;55(2):52-57. PMID: 30351282.
  51. Hanser SB. Music therapy in cardiac health care: current issues in research. Cardiol Rev. 2014 Jan-Feb;22(1):37-42. doi: 10.1097/CRD.0b013e318291c5fc. PMID: 23535529.
  52. Rickerby A, Green R. Barriers to Adopting a Plant-Based Diet in High-Income Countries: A Systematic Review. Nutrients. 2024 Mar 14;16(6):823. doi: 10.3390/nu16060823. PMID: 38542734; PMCID: PMC10975979.
  53. Viroli G, Kalmpourtzidou A, Cena H. Exploring Benefits and Barriers of Plant-Based Diets: Health, Environmental Impact, Food Accessibility and Acceptability. Nutrients. 2023 Nov 8;15(22):4723. doi: 10.3390/nu15224723. PMID: 38004117; PMCID: PMC10675717.
  54. Alcorta A, Porta A, Tárrega A, Alvarez MD, Vaquero MP. Foods for Plant-Based Diets: Challenges and Innovations. Foods. 2021 Feb 1;10(2):293. doi: 10.3390/foods10020293. PMID: 33535684; PMCID: PMC7912826.
  55. Fehér A, Gazdecki M, Véha M, Szakály M, Szakály Z. A comprehensive review of the benefits of and the barriers to the switch to a plant-based diet. Sustainability. 2020;12:4136.
Publish with JBRES — Peer-reviewed, multidisciplinary Open Access with rapid review, DOI, and global visibility.
Double-Blind CrossRef DOI Discoverable
Submit Manuscript Membership