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Triple, Dual Restenosis Prevention Therapies Studied

Three-drug therapy including cilostazol prevents restenosis better than aspirin and clopidogrel

THURSDAY, Jan. 21 (HealthDay News) -- Antiplatelet therapy including aspirin, clopidogrel and cilostazol helps prevent late stenosis following stent placement better than standard therapy with only aspirin and clopidogrel, according to a study in the Jan. 15 issue of the American Journal of Cardiology.

Seung-Whan Lee, M.D., of the University of Ulsan College of Medicine in Seoul, South Korea, and colleagues analyzed two studies on drug protocols to prevent late restenosis after drug-eluting stent placement -- one in patients with diabetes and another in patients with long lesions. In both, the patients were randomized to either triple antiplatelet therapy (aspirin, clopidogrel and cilostazol) or standard dual antiplatelet therapy (aspirin and clopidogrel). The groups were followed for two years for major adverse cardiac events (MACEs), such as death, myocardial infarction, and target lesion revascularization (TLR).

The researchers found that TLRs and MACEs at nine months were significantly decreased in the triple therapy group compared to the standard dual therapy group (2.7 versus 6.9 percent for TLRs and 2.9 versus 7.3 percent for MACEs). After two years, the triple therapy group still had lesser rates of TLRs (4.2 versus 9.1 percent) and MACEs (5.6 versus 10.4 percent).

"In conclusion, compared to the standard group, initial benefit in decreases of nine-month TLRs and MACEs in the triple group was sustained at two years with no differences in death or myocardial infarction. Triple antiplatelet therapy decrease of two-year TLR was favorable in all subgroups, especially in patients with high-risk profiles," the authors write.

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