The effects of dextromethorphan on the outcome of percutaneous coronary intervention with bare-metal stent implantation

Background: In the era of drug-eluting stents, although bare-metal stent (BMS) remains an option for percutaneous coronary intervention (PCI), restenosis remains the Achilles' heel of BMS implantation. A recent study demonstrated several pleiotropic anti-inflammatory effects of dextromethorphan...

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Main Authors: Wen-Cheng Liu, Min-Chien Tsai, Cheng-Chung Cheng, Sy-Jou Chen, Han-Bin Huang, Jun-Ting Liou, Wei-Shiang Lin, Shu-Meng Cheng, Shih-Ping Yang, Tien-Ping Tsao
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2018-01-01
Series:Journal of Medical Sciences
Subjects:
Online Access:http://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2018;volume=38;issue=2;spage=62;epage=66;aulast=Liu
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author Wen-Cheng Liu
Min-Chien Tsai
Cheng-Chung Cheng
Sy-Jou Chen
Han-Bin Huang
Jun-Ting Liou
Wei-Shiang Lin
Shu-Meng Cheng
Shih-Ping Yang
Tien-Ping Tsao
author_facet Wen-Cheng Liu
Min-Chien Tsai
Cheng-Chung Cheng
Sy-Jou Chen
Han-Bin Huang
Jun-Ting Liou
Wei-Shiang Lin
Shu-Meng Cheng
Shih-Ping Yang
Tien-Ping Tsao
author_sort Wen-Cheng Liu
collection DOAJ
description Background: In the era of drug-eluting stents, although bare-metal stent (BMS) remains an option for percutaneous coronary intervention (PCI), restenosis remains the Achilles' heel of BMS implantation. A recent study demonstrated several pleiotropic anti-inflammatory effects of dextromethorphan (DXM). This study aims to evaluate the effects of DXM on the outcome of PCI with BMS implantation.Methods: In this prospective, double-blind, randomized trial, we enrolled 55 patients who underwent PCI with BMS implantation from May 2006 to February 2009. The patients were divided into DXM (60 mg once daily) and placebo groups. We compared mortality rates, myocardial infarction (MI), target lesion revascularization (TLR), restenosis, stent thrombosis, and plasma levels of high-sensitivity C-reactive protein (hs-CRP) with repeated coronary angiography 6 months after the initial procedure.Results: During the 6-month follow-up period, no events of death, MI and stent thrombosis were reported in both groups. The TLR rate was 16.7% in patients receiving DXM compared to 24% receiving a placebo (P = 0.521). The restenosis rate was 30% in patients receiving DXM as compared to 40% receiving the placebo (P = 0.571). Although nonsignificant, the percentage of hs-CRP elevation was lower in the DXM group (20%) compared to the placebo group 32%; P = 0.363).Conclusions: DXM is safe to use in patients who underwent PCI. Although DXM therapy following BMS implantation did not significantly reduce the TLR and restenosis rates, it implied a trend toward a lower TLR and restenosis and reduced inflammation in the DXM group compared to the placebo group. Nonetheless, further extensive studies are warranted to elucidate the anti-restenosis effects of DXM.
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spelling doaj.art-e7d9fb5577bb4fe08c5e8c0e1ae146042022-12-21T17:58:57ZengWolters Kluwer Medknow PublicationsJournal of Medical Sciences1011-45642018-01-01382626610.4103/jmedsci.jmedsci_145_17The effects of dextromethorphan on the outcome of percutaneous coronary intervention with bare-metal stent implantationWen-Cheng LiuMin-Chien TsaiCheng-Chung ChengSy-Jou ChenHan-Bin HuangJun-Ting LiouWei-Shiang LinShu-Meng ChengShih-Ping YangTien-Ping TsaoBackground: In the era of drug-eluting stents, although bare-metal stent (BMS) remains an option for percutaneous coronary intervention (PCI), restenosis remains the Achilles' heel of BMS implantation. A recent study demonstrated several pleiotropic anti-inflammatory effects of dextromethorphan (DXM). This study aims to evaluate the effects of DXM on the outcome of PCI with BMS implantation.Methods: In this prospective, double-blind, randomized trial, we enrolled 55 patients who underwent PCI with BMS implantation from May 2006 to February 2009. The patients were divided into DXM (60 mg once daily) and placebo groups. We compared mortality rates, myocardial infarction (MI), target lesion revascularization (TLR), restenosis, stent thrombosis, and plasma levels of high-sensitivity C-reactive protein (hs-CRP) with repeated coronary angiography 6 months after the initial procedure.Results: During the 6-month follow-up period, no events of death, MI and stent thrombosis were reported in both groups. The TLR rate was 16.7% in patients receiving DXM compared to 24% receiving a placebo (P = 0.521). The restenosis rate was 30% in patients receiving DXM as compared to 40% receiving the placebo (P = 0.571). Although nonsignificant, the percentage of hs-CRP elevation was lower in the DXM group (20%) compared to the placebo group 32%; P = 0.363).Conclusions: DXM is safe to use in patients who underwent PCI. Although DXM therapy following BMS implantation did not significantly reduce the TLR and restenosis rates, it implied a trend toward a lower TLR and restenosis and reduced inflammation in the DXM group compared to the placebo group. Nonetheless, further extensive studies are warranted to elucidate the anti-restenosis effects of DXM.http://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2018;volume=38;issue=2;spage=62;epage=66;aulast=LiuDextromethorphanrestenosisbare-metal stent implantation
spellingShingle Wen-Cheng Liu
Min-Chien Tsai
Cheng-Chung Cheng
Sy-Jou Chen
Han-Bin Huang
Jun-Ting Liou
Wei-Shiang Lin
Shu-Meng Cheng
Shih-Ping Yang
Tien-Ping Tsao
The effects of dextromethorphan on the outcome of percutaneous coronary intervention with bare-metal stent implantation
Journal of Medical Sciences
Dextromethorphan
restenosis
bare-metal stent implantation
title The effects of dextromethorphan on the outcome of percutaneous coronary intervention with bare-metal stent implantation
title_full The effects of dextromethorphan on the outcome of percutaneous coronary intervention with bare-metal stent implantation
title_fullStr The effects of dextromethorphan on the outcome of percutaneous coronary intervention with bare-metal stent implantation
title_full_unstemmed The effects of dextromethorphan on the outcome of percutaneous coronary intervention with bare-metal stent implantation
title_short The effects of dextromethorphan on the outcome of percutaneous coronary intervention with bare-metal stent implantation
title_sort effects of dextromethorphan on the outcome of percutaneous coronary intervention with bare metal stent implantation
topic Dextromethorphan
restenosis
bare-metal stent implantation
url http://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2018;volume=38;issue=2;spage=62;epage=66;aulast=Liu
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