Background: Metallic implants, stents, are increasingly being used especially in patients with stenosis of the cardiac vessels. Ten to thirty per cent of the patients suffer from restenosis regardless of aetiology. We have shown increased frequency of contact allergy to stent metals in stented patients.Objectives: To we evaluate whether contact allergy to stent material is a risk factor for restenosis.Methods: Patients with stainless steel stents, with or without gold plating, were epicutaneously tested and answered a questionnaire. The restenosis rate was evaluated.Results: We found a correlation between contact allergy to gold, gold stent, and restenosis (OR 2.3, CI 1.0-5.1, P ¼ 0.04). The risk for restenosis was threefold increased when the patient was gold allergic and stented with a gold-plated stent. An increased degree of chest pain in gold-allergic patients stented with gold-plated stent was found.Conclusions: We found a correlation between contact allergy to gold, gold-stent, and restenosis. It may be of importance to consider contact allergy when developing new materials for stenting.

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.

In subjects with known coronary atherosclerosis, low-degree inflammatory activity is not only increased in diabetic patients, but also increased with increasing HbA(1c) in non-diabetic individuals with HbA(1c) within the normal range, i.e., at a pre-diabetic level of glucose metabolism derangement.

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.

A 19-year-old woman with anorexia nervosa developed respiratory failure during parenteral nutrition. Serum phosphate concentration was low and the patient had several symptoms typical of hypophosphataemia. It is well known that parenteral refeeding may cause severe hypophosphataemia and this has earlier been described to cause respiratory failure in alcoholics and in patients with intestinal disease. This is, to our knowledge, however, the first reported case of respiratory failure in association with hypophosphataemia occurring in a patient with anorexia nervosa and parenteral nutrition.