Contact allergy to gold in patients with gold‐plated intracoronary stents

Abstract

An increasingly common and effective method for the treatment of atherosclerotic disease in the coronary arteries is percutaneous transluminal coronary angioplasty (PTCA) and stenting. The stents are made of different metals. An increased rate of restenosis when using gold-plated stents has been shown. Contact allergy to gold is common in many countries. Recently, a study has shown an increased rate of contact allergy to nickel among patients with restenosis and a nickel-containing stent. The aims of our study were to investigate whether there was an increased rate of contact allergy to gold among patients with gold-plated stents and if this increased the risk of restenosis. 22 patients who had received a gold-plated stent were patch tested. An age- and sex-matched population of 88 patients, previously patch tested because of a suspected contact dermatitis, served as controls. In the stent group, 10/22 (45.5%) had a contact allergy to gold, in the control group 18/88 (20.5%); the difference is statistically significant (P = 0.04). There was no significant difference regarding frequency of restenosis. Our study indicates that there is a risk of sensitizing the patient when implanting a gold-plated stent. Further studies are needed to confirm these results and to evaluate whether there is an increased risk of restenosis.

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

“…This confirms our previous result from a pilot study where 10 of 22 (45%) patients with a gold-plated stent had a contact allergy to gold. 2 We have also found an approximately 20% higher contact allergy frequency, although not statistically significant, to nickel and palladium in stented patients vs. controls. Basically, the three most plausible explanations to the higher frequencies of contact allergy are that the stented patients (i) have a high frequency of contact allergy in general before stenting, or (ii) have a high frequency of contact allergy to specific metals before stenting or (iii) are sensitized in the coronary vessel.…”

“…1 We have recently shown a high prevalence of contact allergy to gold in patients given gold-plated stents. 2 Gold and nickel are metals that may cause contact allergy in a substantial number of exposed indi-viduals. 3,4 The aim of the present study was to evaluate the frequency of contact allergies to metals used in the stents, especially contact allergy to gold and nickel, in patients who had received one or both of two selected stent types.…”

Outcomes After Coronary Stent Implantation in Patients With Metal Allergy

“…Specific concern was raised in regard to gold. Placement of gold-containing stents appeared to induce systemic sensitization, 15,16 and rates of restenosis were found to be higher in gold-allergic versus nonallergic patients. 12 Such stents are no longer in use.…”

Stent implantation in patients with metal allergy

“…Of the 12 studies selected for further evaluation, one study, which was not a clinical study [7], and another study, which did not describe extractable data, were excluded [8]. A third study was excluded as it was actually an article investigating whether patients with a stent implanted have a higher risk of developing contact allergy [9]. Finally, nine studies [5,6,[10][11][12][13][14][15][16], including 1223 patients, were included in the meta-analysis.…”