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Therapeutic Advances in Cardiovascular Disease
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Review: Avoiding restenosis: is there a role for glucocorticoids in the drug-eluting stent era?

Santiago Jimenez-Valero

Cardiology Unit, Hospital La Paz, Avda. Castellana 261, CP 28046, Madrid, Spain, sjvcardio{at}yahoo.es

Raul Moreno

Cardiology Unit, Hospital La Paz, Avda. Castellana 261, CP 28046, Madrid, Spain

Angel Sanchez-Recalde

Cardiology Unit, Hospital La Paz, Avda. Castellana 261, CP 28046, Madrid, Spain

Guillermo Galeote

Cardiology Unit, Hospital La Paz, Avda. Castellana 261, CP 28046, Madrid, Spain

Luis Calvo

Cardiology Unit, Hospital La Paz, Avda. Castellana 261, CP 28046, Madrid, Spain

Ana Viana

Cardiology Unit, Hospital La Paz, Avda. Castellana 261, CP 28046, Madrid, Spain

Esteban Lopez de Sá

Cardiology Unit, Hospital La Paz, Avda. Castellana 261, CP 28046, Madrid, Spain

Jose López-Sendón

Cardiology Unit, Hospital La Paz, Avda. Castellana 261, CP 28046, Madrid, Spain

Restenosis is an important limitation of percutaneous coronary interventions (PCI). In-stent restenosis is mainly due to neointimal hyperplasia, a proliferative process modulated by inflammatory mechanisms. Numerous technical and pharmacological means have been tested to reduce restenosis rates, with frequently disappointing clinical results. Drug-eluting stents (DES) have demonstrated a high efficacy in reducing restenosis, but there are some associated problems that limit its generalized utilization. Glucocorticoids (GC), as potent anti-inflammatory agents, may exert beneficial effects on neointimal proliferation. Clinical studies with oral and intracoronary GC therapy have demonstrated reduction in restenosis rates in selected patients. Although further investigations are warranted, GC might have a potential role for restenosis prevention in selected cases.

Key Words: Glucocorticoids • stent • steroids • drug-eluting stent • restenosis

Therapeutic Advances in Cardiovascular Disease, Vol. 2, No. 3, 137-146 (2008)
DOI: 10.1177/1753944708090573
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