Comparison of Triple Versus Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation (from the DECLARE-Long Trial)

Seung Whan Lee, Seong Wook Park, Young Hak Kim, Sung Cheol Yun, Duk Woo Park, Cheol Whan Lee, Myeong Ki Hong, Hyun Sook Kim, Jae Ki Ko, Jae Hyeong Park, Jae Hwan Lee, Si Wan Choi, In Whan Seong, Yoon Haeng Cho, Nae Hee Lee, June Hong Kim, Kook Jin Chun, Seung Jung Park

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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 (≥25 mm) requiring a long DES (≥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.

Original languageEnglish
Pages (from-to)1103-1108
Number of pages6
JournalAmerican Journal of Cardiology
Volume100
Issue number7
DOIs
Publication statusPublished - 2007 Oct 1

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Lee, S. W., Park, S. W., Kim, Y. H., Yun, S. C., Park, D. W., Lee, C. W., Hong, M. K., Kim, H. S., Ko, J. K., Park, J. H., Lee, J. H., Choi, S. W., Seong, I. W., Cho, Y. H., Lee, N. H., Kim, J. H., Chun, K. J., & Park, S. J. (2007). Comparison of Triple Versus Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation (from the DECLARE-Long Trial). American Journal of Cardiology, 100(7), 1103-1108. https://doi.org/10.1016/j.amjcard.2007.05.032