Background - Previous COREA-TAXUS trial has shown that the celecoxib, inhibitor of cyclo-oxygenase 2 and akt, can reduce the neointimal formation after paclitaxel-eluting stent (PES) implantation. But the effect of celecoxib on the other drug-eluting stents remains unknown. The study was designed to investigate the different effects of celecoxib on PES and ZES using serial intravascular ultrasound (IVUS).
Methods - The Celecoxib on Restenosis after Coronary Intervention and Evolution of Atherosclerosis (mini-COREA) trial is a randomized, prospective, five-center study to evaluate the effects of celecoxib on restenosis after drug-eluting stents (DES) implantation. Patients were randomized to either celecoxib (for 3 months) or control group after successful DES implantation. IVUS substudy was performed in 454 cases. Quantitative and qualitative IVUS analysis was performed in a core laboratory center in Seoul National University hospital.
Results - At present, 89 serial lesions have been analyzed and the 3-dimensional volumetric IVUS analysis was available in 50 cases (29 PES, 21 ZES). Full analysis results will be available at the meeting. At 6 months, celecoxib decreased neointima volume index (control 0.7 짹 0.9 mm3/mm vs. celecoxib 0.5 짹 0.4 mm3/mm) and % neointima volume obstruction (control 11.5 짹 13.4 % vs. celecoxib 8.7 짹 10.2 %) in PES group. Celecoxib had minimal effect on neointimal hyperplasia in ZES group (% neointima volume obstruction: control 10.4 짹 8.6 % vs. celecoxib 11.3 짹 6.5 %).
Conclusions - This interim analysis suggests that the adjunctive use of celecoxib after PES implantation in patients with coronary artery disease can reduce the neointimal hyperplasia. The effect of celecoxib in reducing neointimal hyperplasia seems to be different between PES and ZES.