title: Comparison of triple versus dual antiplatelet therapy after drug-eluting stent implantation (from the DECLARE-Long trial).
abstract: To evaluate the impact of cilostazol on neointimal hyperplasia after drug-eluting stent (DES) implantation for long coronary lesions, we performed a randomized multicenter prospective study comparing triple antiplatelet therapy (aspirin, clopidogrel, and cilostazol; triple group, n = 250) and dual antiplatelet therapy (aspirin and clopidogrel; standard group, n = 250) for 6 months in patients with long lesions (> or =25 mm) requiring a long DES (> or =32 mm). The primary end point was in-stent late loss at 6-month angiography. The 2 groups had similar baseline clinical and angiographic characteristics. In-stent late loss (0.22 +/- 0.48 mm vs 0.32 +/- 0.51 mm, p = 0.031) and in-segment late loss (0.34 +/- 0.49 mm vs 0.51 +/- 0.49 mm, p = 0.001) at 6-month follow-up angiography were significantly lower in the triple group versus the standard group. There was a trend toward lower rates of in-segment restenosis in the triple group versus the standard group (6.7% vs 11.2%, p = 0.104). Target lesion revascularization (TLR; 2.8% vs 6.8%, p = 0.036) and major adverse cardiac events (2.8% vs 7.6%, p = 0.016), including death, myocardial infarction, and TLR at 9 months were significantly lower in the triple group than in the standard group. At 9 months, the 2 groups had similar rates of stent thrombosis (0.4% vs 0.4%, p = 0.999), death (0% vs 0.8%, p = 0.499), and myocardial infarction (0.4% vs 0.4%, p = 0.999). In conclusion, cilostazol significantly reduced late loss at 6 months after DES implantation and the occurrence of TLR and major adverse cardiac events in patients with long coronary lesions.
authors: Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Seung-Whan
authors: SW
authors: Lee
authors: Seong-Wook
authors: SW
authors: Park
authors: Young-Hak
authors: YH
authors: Kim
authors: Sung-Cheol
authors: SC
authors: Yun
authors: Duk-Woo
authors: DW
authors: Park
authors: Cheol Whan
authors: CW
authors: Lee
authors: Myeong-Ki
authors: MK
authors: Hong
authors: Hyun-Sook
authors: HS
authors: Kim
authors: Jae-Ki
authors: JK
authors: Ko
authors: Jae-Hyeong
authors: JH
authors: Park
authors: Jae-Hwan
authors: JH
authors: Lee
authors: Si Wan
authors: SW
authors: Choi
authors: In-Whan
authors: IW
authors: Seong
authors: Yoon Haeng
authors: YH
authors: Cho
authors: Nae-Hee
authors: NH
authors: Lee
authors: June Hong
authors: JH
authors: Kim
authors: Kook-Jin
authors: KJ
authors: Chun
authors: Seung-Jung
authors: SJ
authors: Park
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D000077407:Cilostazol; D000077144:Clopidogrel; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003331:Coronary Vessels / Q000187:drug effects*; D016503:Drug Delivery Systems; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents; D013777:Tetrazoles / Q000627:therapeutic use; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D017539:Tunica Intima / Q000187:drug effects*
chemical_list: D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine; D017239:Paclitaxel; D001241:Aspirin; D020123:Sirolimus