Abstract 19104: Efficacy and Safety of Celecoxib in Patients With Drug-Eluting Stents Implantation: Volumetric Intravascular Ultrasound Analysis
Background: The Celecoxib on Restenosis after Coronary Intervention and Evolution of Atherosclerosis (mini-COREA) trial is a randomized, prospective, multicenter study to evaluate the effects of celecoxib on restenosis after drug-eluting stents (DES) implantation. The aim of this study was to evaluate the effects of celecoxib on neointima formation and late incomplete stent apposition using serial volumetric intravascular ultrasound (IVUS).
Methods: In the mini-COREA trial, patients were randomized into control or celecoxib group after DES implantation (paclitaxel-eluting stent (PES) or zotarolimus-eluting stent (ZES)). In the celecoxib group, 200 mg of celecoxib was given twice daily for 3 months after the revascularization. Complete serial volumetric IVUS analysis (after DES implantation and at six-month follow-up) was available in 148 patients, including 74 celecoxib patients and 74 controls.
Results: No baseline differences were present in the clinical characteristics or baseline IVUS parameters between the control and celecoxib groups. At six-month follow-up, % neointima volume obstruction was reduced from 14.3±11.3% for the control group to 11.1±7.9% for the celecoxib group (p=0.048), due to the reduction in neointimal volume (neointimal volume index: control 1.0±0.8 mm2 vs. celecoxib 0.8±0.6 mm2, p=0.02). Celecoxib significantly decreased neointima volume in PES (% neointima volume obstruction: control 14.7±11.9 % vs. celecoxib 10.2±7.4%, p=0.0238), but it had minimal effect on neointimal hyperplasia in ZES (% neointima volume obstruction: control 13.3±9.9% vs. celecoxib 13.1±8.7%, p=0.9325). There was no significant difference in the incidence of late incomplete stent apposition between control and celecoxib groups (control 11.4% vs. celecoxib 13.9%, p=0.6183).
Conclusions: The adjunctive use of celecoxib after DES implantation in patients with coronary artery disease can be effective in reducing neointimal hyperplasia without increasing late incomplete stent apposition. The effect of celecoxib in reducing neointimal hyperplasia may be different between PES and ZES.
- © 2010 by American Heart Association, Inc.