To assess the potential risk of long-term steroid use in the setting of coronary angioplasty, 114 patients of 12,883 consecutively treated patients who were on long-term steroids were compared with those not taking steroids. Steroid use was not associated with increased risk of composite major ischemia events but was associated with a threefold risk (p = 0.01) of major vascular complications and a three- to fourfold risk (p = 0.026) of coronary perforation.