Effects of Celecoxib On Restenosis after Coronary Intervention and Evolution of Atherosclerosis (Mini-COREA) Trial: celecoxib, a double-edged sword for patients with angina
European Heart Journal, 03/12/2012
Kang HJ et al. – Three–month adjunctive celecoxib would be useful to reduce late loss (LL) of drug–eluting stent (DES). However, this study may raise the concern about increased thrombotic risk with celecoxib even in patients receiving dual anti–platelet therapy.Methods
- Patients (n = 909) treated for native coronary lesions were randomized into four groups:
- The control or the celecoxib group with stratification by stents:
- 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 procedure.
- The primary endpoint was in–stent late loss (LL) at 6 months.
- In–stent LL was significantly lower in the celecoxib group than the control group (0.64 ± 0.54 vs. 0.55 ± 0.47 mm, P = 0.02).
- The trend of LL reduction in the celecoxib group was maintained in the ZES and PES subgroups, although it did not reach statistical significance.
- There was a trend towards the reduced clinically driven TLR in the celecoxib group (5.7 vs. 3.2%, log–rank P = 0.09), but adverse cardiac events rate did not differ between the two groups (composite of cardiac death, non–fatal myocardial infarction, and TLR; 8.6 vs. 7.7%, log–rank P = 0.84).
- Non–fatal myocardial infarction and cardiac death occurred in 1.6% of the patients in the celecoxib group when compared with 0.2% in the control group (log–rank P = 0.03).