A Randomized, Double-Blind, Multicenter Comparison Study of Triple Antiplatelet Therapy With Dual Antiplatelet Therapy to Reduce Restenosis After Drug-Eluting Stent Implantation in Long Coronary Lesions Results From the DECLARE-LONG II (Drug-Eluting Stenting Followed by Cilostazol Treatment Reduces Late Restenosis in Patients with Long Coronary Lesions) Trial
- Authors
- Lee, Seung-Whan; Park, Seong-Wook; Kim, Young-Hak; Yun, Sung-Cheol; Park, Duk-Woo; Lee, Cheol Whan; Kang, Soo-Jin; Park, Seung-Jung; Lee, Jae-Hwan; Choi, Si Wan; Seong, In-Whan; Lee, Nae-Hee; Cho, Yoon Haeng; Shin, Won-Yong; Lee, Seung-Jin; Lee, Se-Whan; Hyon, Min-Su; Bang, Duk-Won; Choi, Young-Jin; Kim, Hyun-Sook; Lee, Bong-Ki; Lee, Keun; Park, Hoon-Ki; Park, Chang-Bum; Lee, Sang-Gon; Kim, Min-Kyu; Park, Kyoung-Ha; Park, Woo-Jung
- Issue Date
- 15-Mar-2011
- Publisher
- Elsevier BV
- Keywords
- cilostazol; coronary artery disease; triple antiplatelet therapy; zotarolimus-eluting stent
- Citation
- Journal of the American College of Cardiology, v.57, no.11, pp 1264 - 1270
- Pages
- 7
- Journal Title
- Journal of the American College of Cardiology
- Volume
- 57
- Number
- 11
- Start Page
- 1264
- End Page
- 1270
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/16641
- DOI
- 10.1016/j.jacc.2010.10.035
- ISSN
- 0735-1097
1558-3597
- Abstract
- Objectives The purpose of this study was to determine whether cilostazol reduces intimal hyperplasia in patients undergoing long zotarolimus-eluting stent implantation (stent length: >= 30 mm) for native long coronary lesions (length: >= 25 mm). Background Restenosis after drug-eluting stent implantation remains a significant clinical problem in long coronary lesions. Methods Patients (n = 499) were assigned randomly to triple (aspirin, clopidogrel, and cilostazol, triple group: n = 250) or dual antiplatelet therapy (aspirin and clopidogrel and placebo, dual group: n = 249) for 8 months after long zotarolimus-eluting stent implantation. The primary end point was in-stent late loss at the 8-month angiography according to the intention-to-treat principle. Results The 2 groups had similar baseline characteristics. The in-stent (0.56 +/- 0.55 mm vs. 0.68 +/- 0.59 mm, p = 0.045) and in-segment (0.32 +/- 0.54 mm vs. 0.47 +/- 0.54 mm, p = 0.006) late loss were significantly lower in the triple versus dual group, as were 8-month in-stent restenosis (10.8% vs. 19.1%, p = 0.016), in-segment restenosis (12.2% vs. 20.0%, p = 0.028), and 12-month ischemic-driven target lesion revascularization (5.2% vs. 10.0%, p = 0.042) rates. At 12 months, major adverse cardiac events including death, myocardial infarction, and ischemic-driven target lesion revascularization tended to be lower in the triple group than the dual group (7.2% vs. 12.0%, p = 0.07). Percent intimal hyperplasia volume by volumetric intravascular ultrasound analysis was reduced from 27.1 +/- 13.2% for the dual group to 22.1 +/- 9.9% for the triple group (p = 0.017). Conclusions Patients receiving triple antiplatelet therapy after long zotarolimus-eluting stent implantation had decreased extent of late luminal loss, percent intimal hyperplasia volume, and angiographic restenosis, resulting in a reduced risk of 12-month target lesion revascularization compared with patients receiving dual antiplatelet therapy. (Triple Versus Dual Antiplatelet Therapy after ABT578-Eluting Stent; NCT00589927) (J Am Coll Cardiol 2011; 57: 1264-70) (C) 2011 by the American College of Cardiology Foundation
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