Korean J Intern Med.  2011 Mar;26(1):41-46. 10.3904/kjim.2011.26.1.41.

Two-Year Clinical Outcome after Carvedilol-Loaded Stent Implantation in Patients with Coronary Artery Disease

• Kim HK
• Hong YJ
• Jeong MH
• Kim W
• Kim SS
• Ko JS
• Lee MG
• Sim DS
• Park KH
• Yoon NS
• Yoon HJ
• Kim KH
• Park HW
• Kim JH
• Ahn Y
• Cho JG
• Park JC
• Kang JC

• KMID: 1036149
• DOI: http://doi.org/10.3904/kjim.2011.26.1.41

Abstract

BACKGROUND/AIMS
Carvedilol is an antioxidant that inhibits smooth muscle cell proliferation and migration. The aim of this study was to investigate the beneficial effects of carvedilol-loaded stents on 2-year clinical outcomes after stent implantation in patients with coronary artery disease.
METHODS
We performed a prospective trial with male subjects to compare the safety and effects of carvedilol-loaded BiodivYsio(R) stents implanted into 20 patients with those of bare-metal BiodivYsio(R) stents implanted into 21 patients for de novo coronary lesions. The primary end point was the degree of neointimal hyperplasia, which was measured by intravascular ultrasound (IVUS) 6 months after the procedure; the secondary end point was major adverse cardiac events (MACE) at 2 years after implantation. All carvedilol and control stents were deployed successfully.
RESULTS
A 2-year follow-up was completed for 19 patients (95%) in the carvedilol stent group and 20 patients (95%) in the control stent group. IVUS showed a trend toward a larger luminal area (6.86 +/- 2.59 vs. 5.47 +/- 1.52 mm2, p = 0.267), smaller neointimal area (1.34 +/- 0.70 vs. 2.40 +/- 1.73 mm2, p = 0.18), and reduced net decrease in luminal area (-0.78 +/- 0.97 vs. -1.89 +/- 1.78 mm2, p = 0.106) in the carvedilol stent group compared with the control stent group, respectively. There were no significant differences in the incidence of MACE (10.5 vs. 30.0%, respectively, p = 0.132) between the groups at 2 years after stent implantation. Stent thrombosis did not occur in either group after 2 years.
CONCLUSIONS
The carvedilol-loaded stents tended to inhibit neointimal hyperplasia without the occurrence of cardiac death, myocardial infarction, or stent thrombosis at 2-year follow-up.

Keyword

Coronary artery disease; Antioxidants; Stents

MeSH Terms

Aged
*Angioplasty, Balloon, Coronary
Carbazoles/*administration & dosage
Coronary Artery Disease/*therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Propanolamines/*administration & dosage
Prospective Studies
*Stents
Treatment Outcome
Ultrasonography, Interventional