Triple antiplatelet therapy reduces restenosis in long lesions after drug-eluting stent implantation


Data from the DECLARE-LONG II (Drug-eluting stenting followed by cilostazol treatment reduces late restenosis in patients with long coronary lesions) trial show triple antiplatelet therapy decreased late lumen loss and restenosis after the implantation of long zotarolimus-eluting stents, resulting in a reduced risk of 12-month target lesion revascularisationcompared with dual antiplatelet therapy.

Results of the trial were presented at the annual TCT meeting in Washington DC, USA, in September 2010 and recently published in the Journal of the American College of Cardiology.


Investigators led by Seong-Wook Park, Asan Medical Center, Seoul, South Korea randomly assigned 499 patients to triple (n=250) or dualantiplatelet therapy (n=249) for eight months after the implantation of ≥30mm zotarolimus-elutingstents for ≥25mm coronary lesions.


Primary endpoint was in-stent lateloss at the eight-month angiography. In-stent(0.56±0.55mm vs. 0.68±0.59 mm, p=0.045)and in-segment (0.32±0.54mm vs. 0.47±0.54mm, p=0.006) late loss were significantly lower in the tripleversus dual group.


Eight-month in-stent restenosis (10.8%vs. 19.1%, p=0.016), in-segment restenosis (12.2% vs. 20%,p=0.028), and 12-month ischaemic-driven target lesion revascularisation rates(5.2% vs. 10%, p=0.042) were also lower in the triple group.


“At 12 months, major adversecardiac events: death, myocardial infarction, and ischaemic-driventarget lesion revascularisation, were lower in the triplegroup than the dual group (7.2% vs. 12.0%, p=0.07),” investigators reported.