Effects of Celecoxib on Restenosis after Coronary Intervention and Evolution of Atherosclerosis (Mini-COREA) Trial

Celecoxib, a double-edged sword for patients with angina

Hyun Jae Kang, Il Young Oh, Jin Wook Chung, Han Mo Yang, Jung Won Suh, Kyung Woo Park, Taek Keun Kwon, Hae Young Lee, Young Seok Cho, Tae Jin Youn, Bon Kwon Koo, Won Yu Kang, Weon Kim, Seung-Woon Rha, Jang Ho Bae, In Ho Chae, Dong Ju Choi, Hyo Soo Kim

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13 Citations (Scopus)

Abstract

AimsIn the previous COREA-TAXUS trial, a 6-month adjunctive use of celecoxib reduced target-lesion revascularization (TLR) without increased thrombotic risk. We aimed to confirm the effects of 3-month celecoxib in patients receiving drug-eluting stent (DES) implantation in the larger prospective, randomized trial.Methods and resultsPatients (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).ConclusionThree-month adjunctive celecoxib would be useful to reduce LL of DES. However, this study may raise the concern about increased thrombotic risk with celecoxib even in patients receiving dual anti-platelet therapy.

Original languageEnglish
Pages (from-to)2653-2661
Number of pages9
JournalEuropean Heart Journal
Volume33
Issue number21
DOIs
Publication statusPublished - 2012 Nov 1

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Celecoxib
Coronary Restenosis
Atherosclerosis
Stents
Drug-Eluting Stents
Paclitaxel
Control Groups
Myocardial Infarction

Keywords

  • Celecoxib
  • Drug-eluting stent
  • Stent thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effects of Celecoxib on Restenosis after Coronary Intervention and Evolution of Atherosclerosis (Mini-COREA) Trial : Celecoxib, a double-edged sword for patients with angina. / Kang, Hyun Jae; Oh, Il Young; Chung, Jin Wook; Yang, Han Mo; Suh, Jung Won; Park, Kyung Woo; Kwon, Taek Keun; Lee, Hae Young; Cho, Young Seok; Youn, Tae Jin; Koo, Bon Kwon; Kang, Won Yu; Kim, Weon; Rha, Seung-Woon; Bae, Jang Ho; Chae, In Ho; Choi, Dong Ju; Kim, Hyo Soo.

In: European Heart Journal, Vol. 33, No. 21, 01.11.2012, p. 2653-2661.

Research output: Contribution to journalArticle

Kang, HJ, Oh, IY, Chung, JW, Yang, HM, Suh, JW, Park, KW, Kwon, TK, Lee, HY, Cho, YS, Youn, TJ, Koo, BK, Kang, WY, Kim, W, Rha, S-W, Bae, JH, Chae, IH, Choi, DJ & Kim, HS 2012, '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, vol. 33, no. 21, pp. 2653-2661. https://doi.org/10.1093/eurheartj/ehs001
Kang, Hyun Jae ; Oh, Il Young ; Chung, Jin Wook ; Yang, Han Mo ; Suh, Jung Won ; Park, Kyung Woo ; Kwon, Taek Keun ; Lee, Hae Young ; Cho, Young Seok ; Youn, Tae Jin ; Koo, Bon Kwon ; Kang, Won Yu ; Kim, Weon ; Rha, Seung-Woon ; Bae, Jang Ho ; Chae, In Ho ; Choi, Dong Ju ; Kim, Hyo Soo. / Effects of Celecoxib on Restenosis after Coronary Intervention and Evolution of Atherosclerosis (Mini-COREA) Trial : Celecoxib, a double-edged sword for patients with angina. In: European Heart Journal. 2012 ; Vol. 33, No. 21. pp. 2653-2661.
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T2 - Celecoxib, a double-edged sword for patients with angina

AU - Kang, Hyun Jae

AU - Oh, Il Young

AU - Chung, Jin Wook

AU - Yang, Han Mo

AU - Suh, Jung Won

AU - Park, Kyung Woo

AU - Kwon, Taek Keun

AU - Lee, Hae Young

AU - Cho, Young Seok

AU - Youn, Tae Jin

AU - Koo, Bon Kwon

AU - Kang, Won Yu

AU - Kim, Weon

AU - Rha, Seung-Woon

AU - Bae, Jang Ho

AU - Chae, In Ho

AU - Choi, Dong Ju

AU - Kim, Hyo Soo

PY - 2012/11/1

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N2 - AimsIn the previous COREA-TAXUS trial, a 6-month adjunctive use of celecoxib reduced target-lesion revascularization (TLR) without increased thrombotic risk. We aimed to confirm the effects of 3-month celecoxib in patients receiving drug-eluting stent (DES) implantation in the larger prospective, randomized trial.Methods and resultsPatients (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).ConclusionThree-month adjunctive celecoxib would be useful to reduce LL of DES. However, this study may raise the concern about increased thrombotic risk with celecoxib even in patients receiving dual anti-platelet therapy.

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KW - Celecoxib

KW - Drug-eluting stent

KW - Stent thrombosis

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