Coronary artery diseaseComparison of Triple Versus Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation (from the DECLARE–Long Trial)
Section snippets
Patient selection
The detailed Drug-Eluting stenting followed by Cilostazol treatment reduces LAte REstenosis in patients with Long native coronary lesions (DECLARE–Long) protocol has been published,12 including study design, organization, clinical measurement, and angiographic measurement. This prospective randomized study involved 500 patients ≥18 years of age with angina pectoris and/or positive stress test findings and a native coronary lesion. The study involved 5 cardiac centers in Korea between August
Baseline characteristics of the patients
Table 1 lists the baseline clinical characteristics of the 2 groups. There were no significant differences between groups in baseline clinical characteristics and risk factors.
Procedural results and in-hospital outcomes
Table 2 lists angiographic characteristics and procedural results. The 2 groups have similar anatomic and procedural characteristics. All stents were successfully implanted, and the angiographic success rate was 99.2% in both groups. No in-hospital events occurred in either group, including stent thrombosis, Q-wave MI,
Discussion
The major finding of this study is that cilostazol treatment for 6 months is associated with reduction of late loss after DES implantation in long coronary lesions. This translates into a trend toward less angiographic restenosis (p = 0.104) and significant reduction of TLR and major adverse cardiac events.
Cilostazol is a potent oral antiplatelet agent with a rapid onset of action that selectively inhibits phosphodiesterase III and leads to a higher level of cyclic adenosine monophosphate
References (23)
- et al.
Synergistic interactions between selective pharmacological inhibitors of phosphodiesterase isozyme families PDE III and PDE IV to attenuate proliferation rate of vascular smooth muscle cells
Biochem Pharmacol
(1994) - et al.
Effect of cilostazol on angiographic restenosis after coronary stent placement
Am J Cardiol
(2000) - et al.
Predictors of restenosis after placement of drug-eluting stents in one or more coronary arteries
Am J Cardiol
(2006) - et al.
Very long sirolimus-eluting stent implantation for de novo coronary lesions
Am J Cardiol
(2004) - et al.
Multiple overlapping drug-eluting stents to treat diffuse disease of the left anterior descending coronary artery
J Am Coll Cardiol
(2005) - et al.
Frequency of and risk factors for stent thrombosis after drug-eluting stent implantation during long-term follow-up
Am J Cardiol
(2006) - et al.
Relationship between angiographic late loss and target lesion revascularization after coronary stent implantation: analysis from the TAXUS-IV trial
J Am Coll Cardiol
(2005) - et al.
Comparison of cilostazol versus ticlopidine therapy after stent implantation
Am J Cardiol
(1999) - et al.
Comparison of cilostazol and clopidogrel after successful coronary stenting
Am J Cardiol
(2005) A scientific rationale for the CREST trial results: evidence for the mechanism of action of cilostazol in restenosis
Atheroscler Suppl
(2005)
Pharmacologic treatment of intimal hyperplasia after metallic stent placement in the peripheral arteries: an experimental study
Invest Radiol
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2020, Current Problems in SurgeryAn up-dated meta-analysis of major adverse cardiac events on triple versus dual antiplatelet therapy after percutaneous coronary intervention in patients with type 2 diabetes mellitus
2018, Data in BriefCitation Excerpt :One of the articles [1] was excluded because it was a sub-study of another one [2] and was conducted by the same research group. Finally, eight randomized controlled trials (RCTs) [2–9] met the inclusion criteria and were enrolled (Fig. 1). The dosage of cilostazol was 200 mg per day for 6 months.
Comparison of 1-Year Outcomes of Triple (Aspirin + Clopidogrel + Cilostazol) Versus Dual Antiplatelet Therapy (Aspirin + Clopidogrel + Placebo) After Implantation of Second-Generation Drug-Eluting Stents into One or More Coronary Arteries: from the DECREASE-PCI Trial
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2017, Practical CardiologyLack of Evidence for Dual Antiplatelet Therapy after Endovascular Arterial Procedures: A Meta-analysis
2016, European Journal of Vascular and Endovascular Surgery
This study was supported by the Cardiovascular Research Foundation of Korea, grant 0412-CR02-0704-0001 from the Korean Ministry of Health and Welfare as part of the Korea Health 21 Research and Development Project, and a grant from Cordis (a Johnson & Johnson Company), Miami, Florida.