Abstract
Background: The aim of this study was to find most beneficial patients from triple antiplatelet therapy based on association between the length of the stented segment and the risk of angiographic restenosis after drug-eluting stent (DES) implantation. Although triple antiplatelet therapy showed restenosis and repeat revascularization in complex coronary lesions after DES implantation, no practical guideline to use triple antiplatelet therapy was suggested. Methods: Pooled analysis of three randomized studies in patients with DM (DECLARE-DIABETES) and long lesion (DECLARE-LONG I and II) compared triple antiplatelet therapy (aspirin, clopidogrel and cilostazol, triple group, n1⁄4700) and dual antiplatelet therapy (aspirin and clopidogrel, standard group, n1⁄4699) receiving sirolimus(SES), paclitaxel(PES), and zotarolimus-eluting stent (ZES).We analyzed follow-up angiographic outcomes. Results: All patients (n1⁄41399) were divided into 6 categories (£20mm, 20 to 30mm, 30 to 40mm, 40 to 50mm, 50 to 60mm,>60 mm) according to stent length. In-stent restenosis rate was significantly diverged in 40 to 50 mm group (9.4% vs. 24.2%, p1⁄40.005) and 50 to 60 mm category (6.0% vs. 20.3%, p1⁄40.012) between triple and standard group. If lesions were divided into 3 category (£2.5mm, 2.5 to 3.0 mm, >3.0mm) according to post-procedural minimal lumen diameter (MLD), triple group showed lower in-stent restenosis compared to standard group in all categories.
Published Version
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