| ǥ : Clinical award session
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ȣ - 500661 3 |
| Celecoxib Reduces Neointimal Growth and Target Lesion Revascularization after Paclitaxel-Eluting Stents Implantation |
| 서울대학교 의과대학 내과학교실¹ , 서울대학교병원 순환기내과² |
| 김용석¹ ², 구본권¹ ² , 양한모 ¹ ² , 이해영¹ ² , 박진식¹ ² , 강현재¹ ² , 조영석¹ ² , 정우영¹ ² , 김용진¹ ² , 오세일¹ ² , 채인호¹ ² , 최동주¹ ² , 오병희¹ ² , 박영배¹ ² , 최윤식¹ ² , 김효수¹ ² |
Background Several studies have reported the beneficial effect of celecoxib in cardiovascular diseases such as improvement of endothelial function or inflammation. Furthermore, celecoxib has been reported to have anti-restenotic properties after angioplasty in animal model. We performed a prospective, randomized clinical trial to evaluate the effect of celecoxib on restenosis and revascularization in patients with paclitaxel-eluting stents (PES) implantation. Methods and Results A total of 271 patients (mean age, 63.8 years; 66.4% men) planned to undergo PES implantation were randomly assigned to celecoxib (n=134) or control (n=137) group. Celecoxib was started immediately before coronary intervention (loading dose 400mg) and maintained for 6 months (200mg bid). The primary end point was late luminal loss at 6 months. The secondary end points were 6-month rates of target lesion revascularization (TLR), death and myocardial infarction (MI). At present, 6-month clinical follow-up was completed in 183 patients (67.5%) and angiographic follow-up in 163 patients (60.1%). Quantitative angiographic measurements were completed in twenty-nine percent of lesions. (The final data will be presented at the meeting.) The two groups had similar baseline clinical and angiographic characteristics. The postprocedural increase of high sensitivity C-reactive protein after stent implantation was significantly lower in the celecoxib group than control group (0.66±0.68mg/dL vs 0.95±0.92mg/dL, P<0.05). There was the tendency of lower late luminal loss in celecoxib group than control group (0.44±0.57mm vs 0.66±0.75mm, P=0.09). Celecoxib group showed the tendency of lower 6-month TLR rate than control group (9.4% vs 4.6%, P=0.15). There was no significant difference in the incidence of periprocedural MI (celecoxib, 11.7% vs control, 12.9%, P=0.83) or 6-month MI and cardiac death (celecoxib, 0.9% vs control, 1.0%, P=1.00). Conclusions Treatment with celecoxib after PES implantation significantly reduced late luminal loss, which resulted in the reduction of TLR rate compared with control patients without increased thrombotic complication.
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