The Preventive Effect on In-Stent Restenosis of Overlapped Drug-Eluting Stents for Treating Diffuse Coronary Artery Disease

Kim, Weon; Jeong, Myung Ho; Cho, Jae Yeoung; Cho, Jung Sun; Hwang, Seung Hwan; Lee, Sang Rok; Lim, Sang Yup; Hong, Young Joon; Hong, Seo Na; Kim, Kye Hun; Son, Il Suk; Park, Hyung Wook; Kim, Ju Han; Ahn, Young Keun; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee

doi:10.4070/kcj.2006.36.1.17

Cited by 7 publications

(2 citation statements)

References 26 publications

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“…The DES has noticeably reduced the frequency of restenosis, which was one of the most difficult problems associated with bare metal stents. Large scale studies have demonstrated the effectiveness of DES for reducing the frequency of restenosis and major cardiac events 1-7). However, long term follow up studies have reported various additional problems such as stent thrombosis.…”

Section: Introductionmentioning

confidence: 99%

“…Large scale studies have demonstrated the effectiveness of DES for reducing the frequency of restenosis and major cardiac events. 1 - 7) However, long term follow up studies have reported various additional problems such as stent thrombosis. Treatment with dual antiplatelet therapy has reduced the frequency of stent thrombosis in patients treated with DES.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Cilostazol on Stent Thrombosis After Drug-Eluting Stent Implantation

et al. 2010

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Background and ObjectivesPlacement of drug-eluting stents (DES) can be complicated by stent thrombosis; prophylactic antiplatelet therapy has been used to prevent such events. We evaluated the efficacy of cilostazol with regard to stent thrombosis as adjunctive antiplatelet therapy.Subjects and MethodsA total of 1,315 patients (846 males, 469 females) were prospectively enrolled and analyzed for the frequency of stent thrombosis. Patients with known risk factors for stent thrombosis, except diabetes and acute coronary syndrome, were excluded from the study. All patients maintained antiplatelet therapy for at least six months. To evaluate the effects of cilostazol as another option for antiplatelet therapy, triple antiplatelet therapy (aspirin+clopidogrel+cilostazol, n=502) was compared to dual antiplatelet therapy (aspirin+clopidogrel, n=813). Six months after stent placement, all patients received only two antiplatelet drugs: treatment either with cilostazol+aspirin (cilostazol group) or clopidogrel+aspirin (clopidogrel group). There were 1,033 patients (396 in cilostazol group and 637 in clopidogrel group) that maintained antiplatelet therapy for at least 12 months and were included in this study. Stent thrombosis was defined and classified according to the definition reported by the Academic Research Consortium (ARC).Resultsdefined and classified according to the definition reported by the Academic Research Consortium (ARC). Results: During follow-up (561.7±251.4 days), 15 patients (1.14%) developed stent thrombosis between day 1 to day 657. Stent thrombosis occurred in seven patients (1.39%) on triple antiplatelet therapy and four patients (0.49%) on dual antiplatelet therapy (p=NS) within the first six months after stenting. Six months and later, after stent implantation, one patient (0.25%) developed stent thrombosis in the cilostazol group, and three (0.47%) in the clopidogrel group (p=NS).ConclusionDuring the first six months after DES triple antiplatelet therapy may be more effective than dual antiplatelet therapy for the prevention of stent thrombosis. However, after the first six months, dual antiplatelet treatment, with aspirin and cilostazol, may have a better cost benefit ratio for the prevention of stent thrombosis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effect of Cilostazol on Stent Thrombosis After Drug-Eluting Stent Implantation

et al. 2010

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Comparison of Clinical Outcomes after Implantation of First- and Second-Generation Overlapping Drug-Eluting Stents to Treat Diffuse Long Coronary Lesions

Oh¹,

Jeong²,

Rhee³

et al. 2015

Korean J Med

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Background/Aims: Despite improved revascularization techniques, the clinical outcomes of patients with diffuse coronary artery lesions after percutaneous coronary intervention are unsatisfactory. However, few studies have compared the efficacy of first-and second-generation drug-eluting stents (DES) in patients with diffuse long coronary artery lesions. Methods: Between January 2006 and July 2012, 364 patients who were treated with DES for long coronary artery stenosis (> 30 mm) were enrolled in this study and assigned to either Group I (first-generation DES, 62.3 ± 10.4 years, 136 males, n = 183) or Group II (second-generation DES, 64.3 ± 10.7 years, 134 males, n = 181). The incidence of major adverse cardiac events (MACE) was compared between the two groups over 2 years of follow-up, and predictive factors associated with MACE were evaluated through a multivariate analysis. Results: Although several coronary angiographic characteristics were different between the two groups, most demographic and baseline clinical variables were the same. The cumulative incidence of MACE was significantly higher in Group I than in Group II (25.7 vs. 6.6%; p < 0.001), mainly due to reduced target lesion revascularization (21.9 vs. 2.2%; p < 0.001). According to the results of the multivariate analysis, the use of a paclitaxel-eluting stent (PES) (hazard ratio [HR], 5.168; 95% confidence interval [CI], 2.515-10.617; p < 0.001), decreased left ventricular function (≤ 45%; HR, 3.586; 95% CI, 1.839-6.990; p < 0.001), and diabetes mellitus (HR, 2.984; 95% CI, 1.605-5.548; p < 0.001) were independent contributors to MACE.-Kyung Soo Oh, et al. Overlapping DES for diffuse long lesion-193-Conclusions: For patients with diffuse long coronary artery stenosis, the use of second-generation DES improved the clinical outcome compared with first-generation DES. In addition, the use of a PES, left ventricular dysfunction, and diabetes were predictors of MACE after overlapping stenting.

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Treatment of Diffuse Long Coronary Artery Disease with Overlapping Drug-Eluting Stents is Effective?

Kang

Shin

2006

Korean Circ J

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The Preventive Effect on In-Stent Restenosis of Overlapped Drug-Eluting Stents for Treating Diffuse Coronary Artery Disease

Cited by 7 publications

References 26 publications

The Effect of Cilostazol on Stent Thrombosis After Drug-Eluting Stent Implantation

The Effect of Cilostazol on Stent Thrombosis After Drug-Eluting Stent Implantation

Comparison of Clinical Outcomes after Implantation of First- and Second-Generation Overlapping Drug-Eluting Stents to Treat Diffuse Long Coronary Lesions

Treatment of Diffuse Long Coronary Artery Disease with Overlapping Drug-Eluting Stents is Effective?

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