A New Strategy Regarding Discontinuation of Dual Antiplatelet

Inclusion Criteria:

• Coronary artery disease including stable angina, unstable angina, acute non-ST elevation myocardial infarction and acute ST elevation myocardial infarction
• Age 20 years of older
• Patients with typical chest pain or evidences of myocardial ischemia (e.g., stable, unstable angina, silent ischemia and positive functional study or reversible changes in the electrocardiogram (ECG) consistent with ischemia
• Patients with signed informed consent
• Lesion and stent length for ACS and DM subgroup : Length of single lesion < 24 mm and, Summation of total length of all inserted DES in 3 vessel < 60 mm
• Lesion and stent length for ACS and DM subgroup : Length of single lesion < 24 mm and, Summation of total length of all inserted DES in 3 vessel < 60 mm
• Lesion and stent length for long lesion subgroup : Length of single stent per single lesion > 28 mm and, Summation of total length of all inserted DES in 3 vessel ≤ 90 mm, Possible overlapping stent
• Lesion and stent length for short lesion subgroup : Length of single lesion < 24 mm and, Summation of total length of all inserted DES in 3 vessel < 60 mm
• Significant coronary artery stenosis (>50% by visual estimate) considered for coronary revascularization with stent implantation
• Reference vessel diameter of 2.5 to 4.0 mm by operator assessment
• Lesion success (30% or less residual stenosis by visual assessment over the entire stent length, with TIMI-3 flow and no more than an NHLBI type B peri-stent dissection

Exclusion Criteria:

• Contraindication to anti-platelet agents & bleeding history within prior 3 months
• Known hypersensitivity or contraindication to any of the following medications: Heparin, Aspirin, Clopidogrel, limus related drug
• Prior history of the following presentations : Cerebral vascular accident (not including transient ischemic attack, Peripheral artery occlusive diseases, Thromboembolic disease, Stent thrombosis
• Severe hepatic dysfunction (3 times normal reference values)
• Significant renal dysfunction (Serum creatinine > 2.0 mg/dl)
• Significant leukopenia, neutropenia, thrombocytopenia, anemia, or known bleeding diathesis
• Cardiogenic shock
• LVEF < 40%
• Pregnant women or women with potential childbearing
• Life expectancy 3 year
• Overlapped DESs(only long lesion subgroup is possible overlapping)
• Left main disease requiring PCI
• Bifurcation lesion with 2-stent technique
• Target lesions with in-stent restenosis at the stented segment of DES or BMS
• Lesions with chronic total occlusion
• History of PCI with DES
• In-stent restenosis lesion