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Multicenter randomized trial of 3-month cilostazol use in addition to dual antiplatelet therapy after biolimus-eluting stent implantation for long or multivessel coronary artery disease

 Young Jin Youn  ;  Jun-Won Lee  ;  Sung Gyun Ahn  ;  Seung-Hwan Lee  ;  Hyunmin Choi  ;  Cheol Woong Yu  ;  Young Joon Hong  ;  Hyuck Moon Kwon  ;  Myeong-Ki Hong  ;  Yangsoo Jang  ;  Junghan Yoon 
 AMERICAN HEART JOURNAL, Vol.167(2) : 241-248.e1, 2014 
Journal Title
Issue Date
Aged ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/therapy* ; Coronary Restenosis/prevention & control ; Dose-Response Relationship, Drug ; Drug Therapy, Combination ; Drug-Eluting Stents* ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents/pharmacology ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/administration & dosage ; Prospective Studies ; Sirolimus/analogs & derivatives* ; Sirolimus/pharmacology ; Tetrazoles/administration & dosage* ; Ticlopidine/administration & dosage ; Ticlopidine/analogs & derivatives* ; Time Factors ; Treatment Outcome
BACKGROUND: There are conflicting data on the use of cilostazol as triple antiplatelet therapy (TAPT) for improving clinical outcomes after drug-eluting stent implantation. We aimed to evaluate whether 3-month use of cilostazol in addition to dual antiplatelet therapy (DAPT) improved clinical outcomes in patients with long or multivessel coronary artery disease (CAD) after biolimus-eluting stent (BES) implantation. METHODS: Patients (n = 630) who had been successfully treated with BES implantation for lesions with ≥28 mm in stent length or ≥2 stents for different coronary arteries were enrolled in this prospective randomized multicenter trial. All patients were randomly assigned to receive either DAPT (aspirin and clopidogrel for 12 months, n = 314) or TAPT (DAPT plus 3-month cilostazol use, n = 316). The primary end point was a device-oriented composite consisting of cardiac death, myocardial infarction (not clearly attributable to a nontarget vessel), and ischemia-driven target lesion revascularization at 1-year follow-up. RESULTS: A total of 314 patients in DAPT and 308 patients in TAPT were analyzed. Multivessel CAD was present in 65.7% of patients. Stents ≥28 mm in length were implanted in 58.1% of lesions. There were no significant differences in baseline and angiographic characteristics between the 2 groups. The primary end point was similar between the 2 groups (2.3% in DAPT vs 1.9% in TAPT, log-rank P = .799). CONCLUSIONS: In patients treated with BES implantation for long or multivessel CAD, 3 months of cilostazol use in addition to DAPT did not improve clinical outcome at 1-year follow-up.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Hyuck Moon(권혁문) ORCID logo https://orcid.org/0000-0001-9901-5015
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
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