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The effect of celecoxib on restenosis after coronary angioplasty with bare-metal stent: COREA-BMS trial
서울대학교병원¹ 서울대학교분당병원²
정진욱¹, 이해영¹ 강현재¹ 조영석² 연태진² 정우영² 구본권¹ 채인호² 최동주² 김효수¹ 오병희¹ 박영배¹
Background: We recently reported a favorable effect of celecoxib in reducing neointima formation without risk of thrombotic events after angioplasty with TAXUS stent (COREA-TAXUS trial). The aim of this study was to evaluate the anti-restenotic effect of celecoxib after angioplasty with bare-metal stent (BMS). Methods: We collected 70 lesions treated with BMS at index procedure from 65 patients enrolled in COREA-TAXUS trial (a randomized, two-center trial to compare the effects of a 6 month administration of celecoxib with conventional therapy after coronary intervention using paclitaxel-eluting stents). 37 lesions were celecoxib group and 33 lesions were control group. The primary endpoint was late luminal loss on quantitative coronary angiography. The secondary endpoint was target lesion revascularization (TLR). Results: The baseline lesion characteristics were comparable and equally complex in both groups. The mean diameter of the stent was 3.4±0.6 mm for both groups. The mean length of the stent was 19.8±5.8mm for celecoxib group and 20.5±7.8 mm for control group. At 6 months, in-stent late luminal loss was lower in the celecoxib group compared with the control group although this difference failed to reach the statistical significance with small sample size (0.81 vs 1.02 mm, delta=0.21 mm, p=0.11). TLR at 6 months was also lower in the celecoxib group compared with control group although this difference failed to reach the statistical significance (2 [5.4%] vs 6 [18.2%], p=0.14). Conclusions: The addition of celecoxib on top of conventional medications after BMS implantation in this small pilot trial showed a possibility to reduce late luminal loss and incidence of TLR. Larger randomized trials are warranted for confirmation.


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