title: Immunosuppressive therapy with oral prednisone to prevent restenosis after PCI. A multicenter randomized trial.
abstract: BACKGROUND
  Prednisone at immunosuppressive doses after stenting has shown remarkable efficacy in reducing ischemic recurrences in nondiabetic patients with high post-procedural levels of C-reactive protein; the study aim was to compare the clinical outcome obtained in a control group of patients treated with bare metal stents versus 2 other study groups--bare metal stent plus oral prednisone or drug eluting stents--assuming similar optimal adjunctive medical treatment.
  
  
  METHODS
  Five tertiary Italian hospitals enrolled 375 nondiabetic patients with coronary artery disease and no contraindications to dual antiplatelet treatment or corticosteroid therapy in a randomized, controlled study performed between 2007 and 2009. Patients were allocated into 3 study groups: bare metal stents (controls), bare metal stents followed by a 40-day prednisone treatment, or drug-eluting stents. The primary endpoint was the event-free survival of cardiovascular death, myocardial infarction, and recurrence of ischemia needing repeated target vessel revascularization at 1 year as adjudicated by an independent clinical events committee.
  
  
  RESULTS
  One-year follow-up was obtained in all patients. Patients receiving bare metal stents alone as compared to those treated with prednisone or drug-eluting stents had lower event-free survival; the primary endpoint was 80.8% in controls compared to 88.0% in the prednisone and 88.8% in the drug-eluting stent groups, respectively (P=.04 and .006).
  
  
  CONCLUSIONS
  Compared with bare metal stents alone, prednisone treatment after bare metal stents or drug-eluting stent implantation result in a better event-free survival at 1 year.
authors.affiliation: Department of Medicine, University of Verona, Verona, Italy. flavio.ribichini@univr.it
authors.forename: Flavio
authors.initials: F
authors.lastname: Ribichini
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Tomai
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Luca
authors.forename: Giacomo
authors.initials: G
authors.lastname: Boccuzzi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Presbitero
authors.forename: Gabriele
authors.initials: G
authors.lastname: Pesarini
authors.forename: Valeria
authors.initials: V
authors.lastname: Ferrero
authors.forename: Anna S
authors.initials: AS
authors.lastname: Ghini
authors.forename: Ramadan
authors.initials: R
authors.lastname: Abukaresh
authors.forename: Cristina
authors.initials: C
authors.lastname: Aurigemma
authors.forename: Leonardo
authors.initials: L
authors.lastname: De Luca
authors.forename: Dennis
authors.initials: D
authors.lastname: Zavalloni
authors.forename: Daniela
authors.initials: D
authors.lastname: Soregaroli
authors.forename: Paolo
authors.initials: P
authors.lastname: Marino
authors.forename: Roberto
authors.initials: R
authors.lastname: Garbo
authors.forename: Luisa
authors.initials: L
authors.lastname: Zanolla
authors.forename: Corrado
authors.initials: C
authors.lastname: Vassanelli
mesh_terms: D000284:Administration, Oral; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000517:prevention & control*; D023921:Coronary Stenosis / Q000628:therapy*; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007558:Italy; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D012107:Research Design; D015607:Stents; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D011241:Prednisone