| Comparison of Triple antiplatelet therapy and dual antiplatelet therapy in patients at high risk of restenosis after drug-eluting stent implantation (from the DECLARE-DIABETES and -LONG Trials). | |
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MedLine Citation:
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PMID: 20102913 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Although cilostazol has decreased restenosis and target lesion revascularization (TLR) after drug-eluting stent implantation, it is not known if this effect is durable at 2 years. We analyzed 2 randomized studies (Drug-Eluting stenting followed by Cilostazol treatment reduces LAte REstenosis in patients with DIABETES mellitus and Drug-Eluting Stenting Followed by Cilostazol treatment reduces LAte REstenosis in patients with LONG native coronary lesions trials) in which 900 patients were randomly assigned to triple antiplatelet therapy (aspirin, clopidogrel, and cilostazol; triple group, n = 450) and dual antiplatelet therapy (aspirin and clopidogrel; standard group, n = 450) for 6 months in patients with diabetes or long lesions receiving drug-eluting stents. We evaluated 2-year major adverse cardiac events (MACEs) including death, myocardial infarction (MI), and TLR. Nine-month TLRs and MACEs were significantly decreased in the triple versus standard group. At 2 years, the triple group sowed significantly decreased TLRs (4.2% vs 9.1%, hazard ratio 0.45, 95% confidence interval 0.26 to 0.78, p = 0.004) and MACEs (5.6% vs 10.4%, hazard ratio 0.52, 95% confidence interval 0.32 to 0.84, p = 0.008) compared to the standard group with no differences in death and MI. In subgroup analysis, triple antiplatelet therapy decrease of 2-year TLR was favorable in all subgroups, especially in patients with paclitaxel-eluting stents, diabetes mellitus, small vessels, long lesions, and left anterior descending coronary artery lesions. In conclusion, compared to the standard group, initial benefit in decreases of 9-month TLRs and MACEs in the triple group was sustained at 2 years with no differences in death or MI. Triple antiplatelet therapy decrease of 2-year TLR was favorable in all subgroups, especially in patients with high-risk profiles. |
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Authors:
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Seung-Whan Lee; Kook-Jin Chun; Seong-Wook Park; Hyun-Sook Kim; Young-Hak Kim; Sung-Cheol Yun; Won-Jang Kim; Jong-Young Lee; Duk-Woo Park; Cheol Whan Lee; Myeong-Ki Hong; Kyoung-Suk Rhee; Jei Keon Chae; Jae-Ki Ko; Jae-Hyeong Park; Jae-Hwan Lee; Si Wan Choi; Jin-Ok Jeong; In-Whan Seong; Suh Jon; Yoon Haeng Cho; Nae-Hee Lee; June Hong Kim; Seung-Jung Park |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2009-12-03 |
Journal Detail:
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Title: The American journal of cardiology Volume: 105 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-01-27 Completed Date: 2010-02-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 168-73 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary Aspirin / administration & dosage* Coronary Restenosis / diagnosis, epidemiology, prevention & control* Diabetes Complications / complications, pathology, therapy Drug Therapy, Combination Drug-Eluting Stents* Female Follow-Up Studies Graft Occlusion, Vascular / diagnosis, epidemiology, prevention & control Humans Male Middle Aged Platelet Aggregation Inhibitors / administration & dosage* Tetrazoles / administration & dosage* Ticlopidine / administration & dosage, analogs & derivatives* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Platelet Aggregation Inhibitors; 0/Tetrazoles; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 73963-72-1/cilostazol; 90055-48-4/clopidogrel |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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