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Circulation, Vol 81, 1753-1761, Copyright © 1990 by American Heart Association

ARTICLES

A controlled trial of corticosteroids to prevent restenosis after coronary angioplasty. M-HEART Group

CJ Pepine, JW Hirshfeld, RG Macdonald, MA Henderson, TA Bass, S Goldberg, MP Savage, G Vetrovec, M Cowley and AS Taussig
Department of Medicine, University of Florida, Gainesville 32610.

A multicenter, double-blind, placebo-controlled trial was conducted to determine if corticosteroids influence the development of restenosis after successful percutaneous transluminal coronary angioplasty (PTCA). Either placebo or 1.0 g methylprednisolone (steroid) was infused intravenously 2-24 hours before planned PTCA in 915 patients. The PTCA patient success rate was 87% (mean) in the eight centers. There were no differences in clinical or angiographic baseline variables between the two groups. End-point analysis (angiographic restenosis, death, recurrent ischemia necessitating early restudy, and coronary artery bypass graft surgery) showed that there was no significant difference comparing placebo- with steroid-treated patients. Angiographic restudy showed the lesion restenosis rate to be 39% (120 of 307 lesions) after placebo and 40% (117 of 291) after steroid treatment (p = NS). We conclude that pulse steroid pretreatment does not influence the overall restenosis rate after successful PTCA.

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