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

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, Minkyu; Park, Kyoung-Ha; Park, Woo Jung; Investigators, Declare-Long Ii Study

doi:10.1016/j.jacc.2010.10.035

Cited by 101 publications

(74 citation statements)

References 11 publications

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“…A total of 14 trials (13 published in peer-review journals and 1 published online) [9,11,12,13,14,15,16,17,18,19,20,21,22,23] with 5,821 patients were identified from 394 potentially relevant publications.…”

Section: Resultsmentioning

confidence: 99%

Cilostazol-Based Triple Antiplatelet Therapy Compared to Dual Antiplatelet Therapy in Patients with Coronary Stent Implantation: A Meta-Analysis of 5,821 Patients

et al. 2012

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Background: Uncertainties still remain in terms of what kinds of patients benefit most from cilostazol-based triple antiplatelet therapy (TAT) after coronary stenting. Methods: We performed a meta-analysis of all relevant randomized controlled trials (RCTs) to investigate the effect of TAT versus dual antiplatelet therapy (DAT) in terms of major adverse cardiovascular events (MACEs) in patients undergoing coronary stenting. Results: Fourteen RCTs with 5,821 patients were included in this study. TAT was associated with a significant reduction in the risk of MACEs compared to DAT [9.2 vs. 13.4%; odds ratio 0.59 (0.46, 0.76)] with consistent benefits among patients with diabetes, long lesions and small vessels. There were no significant between-group differences in the risk of cardiac death, myocardial infarction, stent thrombosis and bleeding events; however, the risk of target lesion revascularization was significantly lower in the TAT group. TAT resulted in borderline significant reduction in the risk of cardiovascular thrombotic events in unselected patients and significant decrease in patients with acute coronary syndrome [odds ratio 0.51 (0.27, 0.94)]. Conclusion: Under the treatment of standard DAT, the addition of cilostazol is an effective and relatively safe strategy in preventing MACEs after coronary stenting, especially for patients at high risk of restenosis or clinical events.

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Section: Resultsmentioning

confidence: 99%

Cilostazol-Based Triple Antiplatelet Therapy Compared to Dual Antiplatelet Therapy in Patients with Coronary Stent Implantation: A Meta-Analysis of 5,821 Patients

et al. 2012

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“…All treatments were administered by oral gavage. These drugs, alone or in combination, are currently used for the treatment of coagulation disorders in patients with PAD [13,14]. Cilostazol is a phosphodiesterase inhibitor with antiplatelet properties which plays an important role in thrombosis prevention [14].…”

Section: Methodsmentioning

confidence: 99%

“…These drugs, alone or in combination, are currently used for the treatment of coagulation disorders in patients with PAD [13,14]. Cilostazol is a phosphodiesterase inhibitor with antiplatelet properties which plays an important role in thrombosis prevention [14]. PON1-deficient animals of the C57BL/6J genetic background were the progeny of mice provided by the Division of Cardiology of the University of California in Los Angeles [15].…”

Section: Methodsmentioning

confidence: 99%

Paraoxonase-1 Deficiency does not Influence Clopidogrel Antiplatelet Function in Mice

García¹

2015

Cardiol Pharmacol

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Background: Clopidogrel is an antiplatelet agent used in the treatment of vascular diseases. It requires in vivo bio activation linked to the cytochrome P450. Several studies reported that paraoxonase-1 (PON1) was a crucial enzyme in clopidogrel activation, and that patients carrying a variant of the PON1192 gene polymorphism have a high risk of thrombosis. However, these reports were not confirmed by subsequent results. The present study was aimed at investigating whether PON1 deficiency affects the biological action of clopidogrel in mice.

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“…It has a unique suppressive effect on the proliferation of vascular smooth muscle, as shown by its reduction of intimal hyperplasia and restenosis in patients after coronary intervention [61]. Especially in drug-eluting stents, triple antiplatelet therapy with cilostazol, aspirin, and clopidogrel decreased angiographic restenosis, resulting in a reduced risk of target lesion revascularization compared with DAPT in diabetic patients [62] or in drug-eluting stent implantation for long coronary lesions [63]. A preventive effect of cilostazol on restenosis is similarly recognized after CAS [64,65], so these results suggest that cilostazol may be a treatment option as perioperative antiplatelet therapy for CAS.…”

Section: Which Antiplatelet Agents Are Better For Cas?mentioning

confidence: 99%

Antiplatelet Therapy for Carotid Artery Stenting

Enomoto

Yoshimura²

2012

Intervent Neurol

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Carotid artery stenting (CAS) is less invasive and has a lower incidence of systemic complications such as myocardial infarction compared with carotid endarterectomy. However, CAS is known to have a high incidence of ischemic complications due to distal thromboembolism. Progress has been made in the development of various distal protection devices and protection methods aimed at preventing thromboembolism. Similar to these methods, perioperative antiplatelet therapy is also able to play a very important role in the prevention of ischemic events. Dual antiplatelet therapy has become standard for perioperative management of CAS.

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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

Cited by 101 publications

References 11 publications

Cilostazol-Based Triple Antiplatelet Therapy Compared to Dual Antiplatelet Therapy in Patients with Coronary Stent Implantation: A Meta-Analysis of 5,821 Patients

Cilostazol-Based Triple Antiplatelet Therapy Compared to Dual Antiplatelet Therapy in Patients with Coronary Stent Implantation: A Meta-Analysis of 5,821 Patients

Paraoxonase-1 Deficiency does not Influence Clopidogrel Antiplatelet Function in Mice

Antiplatelet Therapy for Carotid Artery Stenting

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