TY - JOUR
T1 - Immunosuppressive therapy with oral prednisone to prevent restenosis after PCI. A multicenter randomized trial
AU - Ribichini, Flavio
AU - Tomai, Fabrizio
AU - De Luca, Giuseppe
AU - Boccuzzi, Giacomo
AU - Presbitero, Patrizia
AU - Pesarini, Gabriele
AU - Ferrero, Valeria
AU - Ghini, Anna S.
AU - Abukaresh, Ramadan
AU - Aurigemma, Cristina
AU - De Luca, Leonardo
AU - Zavalloni, Dennis
AU - Soregaroli, Daniela
AU - Marino, Paolo
AU - Garbo, Roberto
AU - Zanolla, Luisa
AU - Vassanelli, Corrado
PY - 2011/5
Y1 - 2011/5
N2 - 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 groupsbare metal stent plus oral prednisone or drug eluting stentsassuming similar optimal adjunctive medical treatment. 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. 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). 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.
AB - 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 groupsbare metal stent plus oral prednisone or drug eluting stentsassuming similar optimal adjunctive medical treatment. 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. 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). 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.
KW - Coronary artery disease
KW - Prednisone
KW - Randomized clinical trial
KW - Stent
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U2 - 10.1016/j.amjmed.2010.11.027
DO - 10.1016/j.amjmed.2010.11.027
M3 - Article
C2 - 21531233
AN - SCOPUS:79955603100
VL - 124
SP - 434
EP - 443
JO - American Journal of Medicine
JF - American Journal of Medicine
SN - 0002-9343
IS - 5
ER -