title: Effects of oral prednisone after stenting in a rabbit model of established atherosclerosis.
abstract: OBJECTIVE
  The aim of this study was to compare the effects of systemic prednisone in combination with a bare-metal stent (BMS) or a paclitaxel-eluting stent (Taxus, Boston Scientific Corp., Natick, Massachusetts) on neointimal inhibition and vessel healing in an atherosclerotic rabbit model.
  
  
  BACKGROUND
  Inflammation plays a critical role in neointimal formation after coronary artery stenting. The efficacy of immunosuppressive doses of oral prednisone to inhibit in-stent neointimal proliferation was compared with BMS and with a commercially available paclitaxel-eluting stent (Taxus) in a rabbit model of established atherosclerosis.
  
  
  METHODS
  Bilateral iliac artery injury in atherosclerotic New Zealand White rabbits fed an atherogenic diet was followed by stent implantation. Animals randomly received Taxus stents, BMS (Express, Boston Scientific Corp.) and placebo, or BMS and oral prednisone (2.1 mg/kg/day for the first 7 days, followed by 1.4 mg/kg/day for 14 days and 0.7 mg/kg/day for 21 days). Stented arterial segments were harvested at 42 days and processed for light microscopy, immunohistochemistry, and organoid culture.
  
  
  RESULTS
  Compared with control subjects, prednisone-treated animals showed a 30% reduction in percent stenosis (p = 0.009), a 35% decrease in neointimal area (p < 0.003), and a 66% decrement in neointimal thickness (p < 0.001). Taxus stents also reduced all 3 parameters significantly (-34%, -39%, and -83%, respectively), but showed significantly more inflammatory cells and fibrin deposition and less endothelialization compared with the other 2 groups. Plaque burden was equal among groups, as shown by the identical stent and vessel area, and no remodeling was observed.
  
  
  CONCLUSIONS
  Systemic prednisone treatment and Taxus stents reduce neointimal formation compared with BMS. The extent of neointimal reduction is similar between prednisone- and Taxus stent-treated animals; however, Taxus stents resulted in a significantly greater delay in healing. Targeting of inflammatory pathways after percutaneous coronary intervention may be an efficacious way to prevent restenosis without the long-term risk of late thrombosis.
authors.affiliation: Division of Cardiology of the Università di Verona, Ospedale Civile Maggiore, Verona, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Ribichini
authors.forename: Michael
authors.initials: M
authors.lastname: Joner
authors.forename: Valeria
authors.initials: V
authors.lastname: Ferrero
authors.forename: Aloke V
authors.initials: AV
authors.lastname: Finn
authors.forename: Johanna
authors.initials: J
authors.lastname: Crimins
authors.forename: Gaku
authors.initials: G
authors.lastname: Nakazawa
authors.forename: Eduardo
authors.initials: E
authors.lastname: Acampado
authors.forename: Frank D
authors.initials: FD
authors.lastname: Kolodgie
authors.forename: Corrado
authors.initials: C
authors.lastname: Vassanelli
authors.forename: Renu
authors.initials: R
authors.lastname: Virmani
mesh_terms: D000284:Administration, Oral; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001011:Aorta / Q000166:cytology / Q000187:drug effects; D050197:Atherosclerosis / Q000473:pathology / Q000628:therapy*; D049109:Cell Proliferation / Q000187:drug effects; D002478:Cells, Cultured; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D005938:Glucocorticoids / Q000627:therapeutic use; D007083:Iliac Artery / Q000473:pathology; D032389:Myocytes, Smooth Muscle / Q000187:drug effects; D011241:Prednisone / Q000494:pharmacology / Q000627:therapeutic use*; D011817:Rabbits; D015607:Stents
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011241:Prednisone