Document Detail


Cilostazol in addition to aspirin and clopidogrel improves long-term outcomes after percutaneous coronary intervention in patients with acute coronary syndromes: a randomized, controlled study.
MedLine Citation:
PMID:  19332203     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cilostazol has been widely used to prevent peripheral vascular events, and its antiplatelet mechanisms may different from aspirin and clopidogrel. We hypothesized that cilostazol in addition to aspirin and clopidogrel effectively reduces systemic ischemic events after percutaneous coronary intervention (PCI) in high-risk patients.
METHODS: In this prospective study, 1,212 patients with acute coronary syndromes were randomly assigned to receive either standard dual-antiplatelet treatment with aspirin and clopidogrel (n = 608) or triple-antiplatelet therapy with the addition of a 6-month course of cilostazol (n = 604) after successful PCI. The primary end point was a composite of cardiac death, nonfatal myocardial infarction, stroke, or target vessel revascularization (TVR) at 1 year after randomization. The secondary end points were TVR and hemorrhagic events.
RESULTS: Triple-antiplatelet treatment was associated with a significantly lower incidence of the primary end points (10.3% vs 15.1%; P = .011). The need for TVR was similar between patients who received triple- and dual-antiplatelet treatment (7.9% vs 10.7%; P = .10). Multivariate analysis showed that female patients and clinically or angiographically high-risk patients benefited more from the triple-antiplatelet treatment. There were no significant differences between the 2 regimens in terms of the risks for major and minor bleeding.
CONCLUSIONS: For patients with acute coronary syndromes, triple-antiplatelet therapy consisting of cilostazol, aspirin, and clopidogrel reduced long-term cardiac and cerebral events after PCI, especially for patients with high-risk profiles.
Authors:
Yaling Han; Yi Li; Shouli Wang; Quanmin Jing; Zhulu Wang; Dongmei Wang; Qingfen Shu; Xiuying Tang
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-03-17
Journal Detail:
Title:  American heart journal     Volume:  157     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-31     Completed Date:  2009-04-21     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  733-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Shenyang Northern Hospital, China. hanyaling.nh@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / physiopathology,  radiography,  therapy*
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary / methods*
Aspirin / therapeutic use*
Drug Therapy, Combination
Electrocardiography / drug effects
Female
Follow-Up Studies
Humans
Male
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use
Prospective Studies
Tetrazoles / therapeutic use*
Ticlopidine / analogs & derivatives*,  therapeutic use
Time Factors
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 0/Tetrazoles; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; A74586SNO7/clopidogrel; N7Z035406B/cilostazol

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