Background: In the Effect of Celecoxib on Restenosis after Coronary Angioplasty with Taxus Stent (COREA-TAXUS) trial, celecoxib reduced late luminal loss and need for target lesion revascularization (TLR) at 6 months. This study was performed to assess the long-term efficacy and safety of adjunctive celecoxib treatment after paclitaxel-eluting stent (PES) implantation.
Method: We evaluated 2-year clinical follow-up of COREA-TAXUS trial, where 274 patients were randomly assigned to receive or not to receive celecoxib (400 mg before the intervention, and 200 mg twice daily for 6 months after the procedure) and underwent PES implantation for native coronary lesions. Cardiac events were cardiac death, non-fatal myocardial infarction, and TLR.
Results: Clinical outcomes at both 9 and 24 months were obtained in 267 patients. At 9 months, cardiac events were significantly reduced in the celecoxib group (5.4% versus 17.5%, P=0.002), mainly because of reduced need for TLR (5.4% versus 16.8%, P=0.003). At 24 months, the rate of cardiac event was consistently lower in the celecoxib group (6.9% versus 19.7%, P=0.002). A significant difference in need for TLR was maintained (6.2% versus 18.2%, P=0.003). There was no difference in the rate of cardiac death or myocardial infarction at 9 months (0.8% versus 0.7%) and at 24 months (1.5% versus 1.4%) between two groups.
Conclusions: Short-term adjunctive celecoxib treatment was clinically effective and safe up to 2 years after PES implantation. However, the small number of thrombotic events in this study warrants larger studies for a more valid conclusion about safety of this treatment.
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