| 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. | |
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MedLine Citation:
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PMID: 21392640 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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). |
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Authors:
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Seung-Whan Lee; Seong-Wook Park; Young-Hak Kim; Sung-Cheol Yun; Duk-Woo Park; Cheol Whan Lee; Soo-Jin Kang; Seung-Jung Park; Jae-Hwan Lee; Si Wan Choi; In-Whan Seong; Nae-Hee Lee; Yoon Haeng Cho; Won-Yong Shin; Seung-Jin Lee; Se-Whan Lee; Min-Su Hyon; Duk-Won Bang; Young-Jin Choi; Hyun-Sook Kim; Bong-Ki Lee; Keun Lee; Hoon-Ki Park; Chang-Bum Park; Sang-Gon Lee; Min-Kyu Kim; Kyoung-Ha Park; Woo-Jung Park; |
Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 57 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-11 Completed Date: 2011-05-16 Revised Date: 2013-05-30 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1264-70 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. swpark@amc.seoul.kr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aspirin / administration & dosage* Coronary Artery Disease / radiography, therapy Coronary Restenosis / etiology, prevention & control*, radiography Double-Blind Method Drug Therapy, Combination Drug-Eluting Stents / adverse effects* Female Follow-Up Studies Humans Male Middle Aged Platelet Aggregation Inhibitors / administration & dosage* Prospective Studies 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; A74586SNO7/clopidogrel; N7Z035406B/cilostazol |
| Comments/Corrections | |
Comment In:
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Nat Rev Cardiol. 2011 Jun;8(6):304
[PMID:
21451468
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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