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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14 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

Keywords

  • Celecoxib
  • Drug-eluting stent
  • Stent thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Kang, H. J., Oh, I. Y., Chung, J. W., Yang, H. M., Suh, J. W., Park, K. W., Kwon, T. K., Lee, H. Y., Cho, Y. S., Youn, T. J., Koo, B. K., Kang, W. Y., Kim, W., Rha, S. W., Bae, J. H., Chae, I. H., Choi, D. J., & Kim, H. S. (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, 33(21), 2653-2661. https://doi.org/10.1093/eurheartj/ehs001