Document Detail


Randomized comparison of cilostazol versus ticlopidine hydrochloride for antiplatelet therapy after coronary stent implantation for prevention of late restenosis.
MedLine Citation:
PMID:  12177649     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cilostazol is a newly developed antiplatelet drug that has been widely applied for clinical use. Its antiplatelet action appears to be mainly related to inhibition of intracellular phosphodiesterase activity. Recently, cilostazol has been used for antiplatelet therapy after coronary stent implantation. However, its evaluation has not been established yet.
METHODS: This prospective randomized trial was designed to investigate the efficacy of cilostazol for the prevention of late restenosis and acute or subacute stent thrombosis in comparison with ticlopidine hydrochloride. One hundred thirty consecutive patients, scheduled for elective coronary stenting, were randomly assigned to receive oral aspirin (81 mg/day) plus ticlopidine hydrochloride therapy (200 mg/day; group I) or aspirin plus cilostazol therapy (200 mg/day; group II). These medications were started at least 2 days before coronary intervention and continued until follow-up coronary angiography was performed 6 months later.
RESULTS: Subacute stent thrombosis was observed in 2 patients of group I but in no patients of group II. Major cardiac events were similarly present in both groups. Elevated transaminase levels were observed more frequently in group I than in group II (P <.05). Each of the quantitative coronary angiography variables before and immediately after coronary stenting were similar in both groups. At follow-up angiography, however, late lumen loss (0.69 +/- 0.79 mm vs 0.28 +/- 0.40 mm; P <.01) and loss index (0.42 +/- 0.56 vs 0.16 +/- 0.27; P <.01) were smaller in group II than in group I. Restenosis rate (13% vs 31%; P <.05) and target lesion revascularization rate (7% vs 21%; P <.05) were both lower in group II than in group I.
CONCLUSION: Aspirin plus cilostazol therapy may be an effective regimen for prevention of not only stent thrombosis but also restenosis.
Authors:
Hirotoshi Kamishirado; Teruo Inoue; Keiichi Mizoguchi; Toshihiko Uchida; Toshiyuki Nakata; Masashi Sakuma; Kan Takayanagi; Shigenori Morooka
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  144     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-14     Completed Date:  2002-09-04     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:  303-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aspirin / administration & dosage
Coronary Angiography
Coronary Disease / therapy*
Coronary Restenosis / etiology,  prevention & control*,  radiography
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Male
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use*
Postoperative Care
Prospective Studies
Research Design
Stents* / adverse effects
Tetrazoles / therapeutic use*
Ticlopidine / therapeutic use*
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 0/Tetrazoles; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; N7Z035406B/cilostazol

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