Article ID Journal Published Year Pages File Type
5963763 International Journal of Cardiology 2016 8 Pages PDF
Abstract

BackgroundStent design and technological modifications to allow for anti-proliferative drug elution influence restenosis rates following percutaneous coronary intervention (PCI). We aimed to investigate whether peri-procedural administration of corticosteroids or the use of thinner strut cobalt alloy stents would reduce rates of binary angiographic restenosis (BAR) after PCI.MethodsThis was a two centre, mixed single and double blinded, randomised controlled trial using a factorial design. We compared (a) the use of prednisolone to placebo, starting at least six hours pre-PCI and continued for 28 days post-PCI, and (b) cobalt chromium (CoCr) to stainless steel (SS) alloy stents, in patients admitted for PCI. The primary end-point was BAR at six months.Results315 patients (359 lesions) were randomly assigned to either placebo (n = 145) or prednisolone (n = 170) and SS (n = 160) or CoCr (n = 160). The majority (58%) presented with an ACS, 11% had diabetes and 287 (91%) completed angiographic follow up. BAR occurred in 26 cases in the placebo group (19.7%) versus 31 cases in the prednisolone group (20.0%) respectively, p = 1.00. For the comparison between SS and CoCr stents, BAR occurred in 32 patients (21.6%) versus 25 patients (18.0%) respectively, p = 0.46.ConclusionOur study showed that treating patients with a moderately high dose of prednisolone for 28 days following PCI with BMS did not reduce the incidence of BAR. In addition, we showed no significant reduction in 6 month restenosis rates with stents composed of CoCr alloy compared to SS (http://www.isrctn.com/ISRCTN05886349).

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