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High frequency of contact allergy to gold in patients with endovascular coronary stents

Ekqvist, Susanne LU ; Svedman, Cecilia LU ; Möller, Halvor LU ; Kehler, M. ; Pripp, C. M. ; Björk, Jonas LU ; Gruvberger, Birgitta LU ; Holmstrom, E ; Gustavsson, C. G. and Bruze, Magnus LU (2007) In British Journal of Dermatology 157(4). p.730-738
Abstract
Background Stent implantation is an effective method for treatment of atherosclerotic disease. Factors predisposing to in-stent restenosis are still largely unknown. Contact allergy to metal ions eluted from the stent has been suggested to be a risk factor. Objectives To explore whether there is a possible induction of contact allergy to metals used in stents among patients with a stainless steel stent containing nickel (Ni stent) and patients with a gold-plated stent (Au stent). Methods Adults (n = 484) treated with coronary stent implantation participated in the study with patch testing. The study design was retrospective and cross-sectional with no assessment of contact allergy before stenting. Age- and sex-matched patch-tested patients... (More)
Background Stent implantation is an effective method for treatment of atherosclerotic disease. Factors predisposing to in-stent restenosis are still largely unknown. Contact allergy to metal ions eluted from the stent has been suggested to be a risk factor. Objectives To explore whether there is a possible induction of contact allergy to metals used in stents among patients with a stainless steel stent containing nickel (Ni stent) and patients with a gold-plated stent (Au stent). Methods Adults (n = 484) treated with coronary stent implantation participated in the study with patch testing. The study design was retrospective and cross-sectional with no assessment of contact allergy before stenting. Age- and sex-matched patch-tested patients with dermatitis (n = 447) served as controls. Results Of Au-stented patients, 54 of 146 (37%) were allergic to gold compared with 85 of 447 (19%) controls (P < 0.001). Within the stented population there were no statistically significant differences in contact allergy to gold or nickel between Ni-stented and Au-stented patients. In multivariate models where other risk factors for contact allergy to gold were considered, the Au stent showed a trend towards statistical significance (odds ratio 1.43, 95% confidence interval 0.95-2.16; P = 0.09). Conclusions As the frequency of contact allergy to gold is higher in stented patients independent of stent type it suggests a previous sensitization. However, several pieces of circumstantial evidence as well as statistical analysis indicate the possibility of sensitization in the coronary vessel by the Au stent. Ni stents and Au stents should not be ruled out as risk factors for induction of contact allergy to these metals. (Less)
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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
gold, nickel, contact allergy, stent
in
British Journal of Dermatology
volume
157
issue
4
pages
730 - 738
publisher
Wiley-Blackwell
external identifiers
  • wos:000249376900014
  • scopus:34548550726
ISSN
1365-2133
DOI
10.1111/j.1365-2133.2007.08119.x
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Cardiology (013230026), Dermatology (013241300), Occupational and Environmental Dermatology Unit (013241310), Pediatrics/Urology/Gynecology/Endocrinology (013240400), Division of Occupational and Environmental Medicine (013078001), Centre for Economic Demography (012019200)
id
38b62f5c-649c-4db2-a1c8-73619e521b46 (old id 688372)
date added to LUP
2016-04-01 11:59:43
date last changed
2022-04-05 08:06:50
@article{38b62f5c-649c-4db2-a1c8-73619e521b46,
  abstract     = {{Background Stent implantation is an effective method for treatment of atherosclerotic disease. Factors predisposing to in-stent restenosis are still largely unknown. Contact allergy to metal ions eluted from the stent has been suggested to be a risk factor. Objectives To explore whether there is a possible induction of contact allergy to metals used in stents among patients with a stainless steel stent containing nickel (Ni stent) and patients with a gold-plated stent (Au stent). Methods Adults (n = 484) treated with coronary stent implantation participated in the study with patch testing. The study design was retrospective and cross-sectional with no assessment of contact allergy before stenting. Age- and sex-matched patch-tested patients with dermatitis (n = 447) served as controls. Results Of Au-stented patients, 54 of 146 (37%) were allergic to gold compared with 85 of 447 (19%) controls (P &lt; 0.001). Within the stented population there were no statistically significant differences in contact allergy to gold or nickel between Ni-stented and Au-stented patients. In multivariate models where other risk factors for contact allergy to gold were considered, the Au stent showed a trend towards statistical significance (odds ratio 1.43, 95% confidence interval 0.95-2.16; P = 0.09). Conclusions As the frequency of contact allergy to gold is higher in stented patients independent of stent type it suggests a previous sensitization. However, several pieces of circumstantial evidence as well as statistical analysis indicate the possibility of sensitization in the coronary vessel by the Au stent. Ni stents and Au stents should not be ruled out as risk factors for induction of contact allergy to these metals.}},
  author       = {{Ekqvist, Susanne and Svedman, Cecilia and Möller, Halvor and Kehler, M. and Pripp, C. M. and Björk, Jonas and Gruvberger, Birgitta and Holmstrom, E and Gustavsson, C. G. and Bruze, Magnus}},
  issn         = {{1365-2133}},
  keywords     = {{gold; nickel; contact allergy; stent}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{730--738}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{British Journal of Dermatology}},
  title        = {{High frequency of contact allergy to gold in patients with endovascular coronary stents}},
  url          = {{http://dx.doi.org/10.1111/j.1365-2133.2007.08119.x}},
  doi          = {{10.1111/j.1365-2133.2007.08119.x}},
  volume       = {{157}},
  year         = {{2007}},
}