title: Immunosuppressive oral prednisone after percutaneous interventions in patients with multi-vessel coronary artery disease. The IMPRESS-2/MVD study.
abstract: OBJECTIVE
  To assess efficacy and safety of oral treatment with prednisone at immunosuppressive dose after percutaneous coronary interventions (PCI) in patients with multi-vessel coronary artery disease (CAD).
  
  
  RESULTS
  Eighty-six consecutive patients with multi-vessel CAD were successfully treated with multiple PCI. Forty-three patients (115 coronary stenoses), with C-reactive protein >3mg/L 48 hours after PCI and in absence of contra-indications received 45-day high-dose oral prednisone treatment (study-group). Forty-three patients (106 coronary stenoses), did not receive prednisone (control-group). The primary clinical endpoint was 12-month event-free survival rate (defined as freedom from death, myocardial infarction, and the need for target vessel revascularisation). Angiographic restenosis at 8 months was assessed in the study group only. Event-free survival rates were 93 and 69.8% in the study and the control group, respectively (relative risk 0.34, 95%CI: 0.12 to 0.96, p=0.006). Target vessel revascularisation rate in the study group was 7% compared to 27.9% in the control group (p=0.01). Quantitative coronary angiography performed on 104 lesions of 39 prednisone-treated patients (91%) showed 4 restenotic lesions (3.8%). The mean late lumen loss was 0.61+/-0.35mm and loss index 31.3+/-21.6%.
  
  
  CONCLUSIONS
  Oral immunosuppression with prednisone effectively reduces clinical restenosis in patients undergoing complex, multi-vessel PCI.
authors.affiliation: atheterisation Laboratory of the Division of Cardiology, Universita' del Piemonte Orientale, Ospedale Maggiore della Carita', Novara, the Division of Cardiac Surgery, Universita' Tor Vergata, Rome, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Ribichini
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Tomai
authors.forename: Valeria
authors.initials: V
authors.lastname: Ferrero
authors.forename: Francesco
authors.initials: F
authors.lastname: Versaci
authors.forename: Giacomo
authors.initials: G
authors.lastname: Boccuzzi
authors.forename: Igino
authors.initials: I
authors.lastname: Proietti
authors.forename: Francesco
authors.initials: F
authors.lastname: Prati
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
authors.forename: Corrado
authors.initials: C
authors.lastname: Vassanelli