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Immunosuppressive therapy with oral prednisone to prevent restenosis after PCI. A multicenter randomized trial.
- Source :
-
The American journal of medicine [Am J Med] 2011 May; Vol. 124 (5), pp. 434-43. - Publication Year :
- 2011
-
Abstract
- Background: Prednisone at immunosuppressive doses after stenting has shown remarkable efficacy in reducing ischemic recurrences in nondiabetic patients with high post-procedural levels of C-reactive protein; the study aim was to compare the clinical outcome obtained in a control group of patients treated with bare metal stents versus 2 other study groups--bare metal stent plus oral prednisone or drug eluting stents--assuming similar optimal adjunctive medical treatment.<br />Methods: Five tertiary Italian hospitals enrolled 375 nondiabetic patients with coronary artery disease and no contraindications to dual antiplatelet treatment or corticosteroid therapy in a randomized, controlled study performed between 2007 and 2009. Patients were allocated into 3 study groups: bare metal stents (controls), bare metal stents followed by a 40-day prednisone treatment, or drug-eluting stents. The primary endpoint was the event-free survival of cardiovascular death, myocardial infarction, and recurrence of ischemia needing repeated target vessel revascularization at 1 year as adjudicated by an independent clinical events committee.<br />Results: One-year follow-up was obtained in all patients. Patients receiving bare metal stents alone as compared to those treated with prednisone or drug-eluting stents had lower event-free survival; the primary endpoint was 80.8% in controls compared to 88.0% in the prednisone and 88.8% in the drug-eluting stent groups, respectively (P=.04 and .006).<br />Conclusion: Compared with bare metal stents alone, prednisone treatment after bare metal stents or drug-eluting stent implantation result in a better event-free survival at 1 year.<br /> (Copyright © 2011 Elsevier Inc. All rights reserved.)
- Subjects :
- Administration, Oral
Aged
Disease-Free Survival
Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Immunosuppressive Agents administration & dosage
Italy
Male
Middle Aged
Prednisone administration & dosage
Research Design
Treatment Outcome
Angioplasty, Balloon, Coronary
Coronary Restenosis prevention & control
Coronary Stenosis therapy
Immunosuppressive Agents therapeutic use
Prednisone therapeutic use
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 1555-7162
- Volume :
- 124
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The American journal of medicine
- Publication Type :
- Academic Journal
- Accession number :
- 21531233
- Full Text :
- https://doi.org/10.1016/j.amjmed.2010.11.027