title: Hydrocortisone reduces restenosis after stenting of small coronary arteries.
abstract: Stenting of small coronary arteries has been limited by high rates of restenosis, and restenosis after stenting has chiefly been attributed to inflammatory reactions resulting in cell proliferation and intimal hyperplasia. In order to suppress this inflammatory process, we examined the effects of hydrocortisone, an antiinflammatory agent, on restenosis after stenting in a nonrandomized retrospective registry. The study population consisted of 193 patients treated at two hospitals, who underwent stent implantations in coronary arteries of reference diameter <3 mm between February 1999 and September 2001. Target lesions included complex, restenotic, diabetic, or chronic total lesions and types of implanted stents were Multi-Link, S-series, and gfx stents. Effect of intravenous administration of hydrocortisone (200 mg) before stenting was compared to control patients who did not receive this treatment. There was no significant difference of early outcomes between the hydrocortisone group and the control group. On angiographic follow-up at 6 months after stenting, the rate of restenosis was significantly lower in patients treated with hydrocortisone as compared with control group (22.8% vs 37%, respectively; P < 0.05). The revascularization rate of target lesion at 6 months was also significantly lower in the treated group (16.5% vs 29%, respectively; P < 0.05). These results suggest that preprocedural intravenous administration of hydrocortisone reduces restenosis after stenting of small coronary arteries. Prospectively controlled trials will be necessary to confirm this preventive effect of hydrocortisone on coronary in-stent restenosis.
authors.affiliation: Department of Cardiology, Daio Municipal Hospital, Daio, Mie, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kakio
authors.forename: Akira
authors.initials: A
authors.lastname: Matsumori
authors.forename: Naohiro
authors.initials: N
authors.lastname: Ohashi
authors.forename: Takehiko
authors.initials: T
authors.lastname: Yamada
authors.forename: Takeji
authors.initials: T
authors.lastname: Saito
authors.forename: Akira
authors.initials: A
authors.lastname: Kawamoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Taguchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Morita
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Shigetake
authors.initials: S
authors.lastname: Sasayama
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016022:Case-Control Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control*; D003331:Coronary Vessels / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000627:therapeutic use*; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D006854:Hydrocortisone