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Temporary Adjunctive Cilostazol vs Clopidogrel Loading for ST-segment Elevation Acute Myocardial Infarction.
MedLine Citation:
PMID:  24452598     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Clopidogrel loading is a standard method to achieve rapid platelet inhibition and prevent thrombotic events. At the current time, little information is available to determine the effect of adjunctive cilostazol compared with clopidogrel loading.
METHODS: We retrospectively analyzed 212 patients undergoing primary percutaneous coronary intervention with drug-eluting stents for ST-segment elevation acute myocardial infarction. All patients were administered aspirin (100 mg once a day) and clopidogrel (75 mg once a day). The patients were divided into two groups according to the presence (loading group, n = 100) or absence (cilostazol group, n = 112) of clopidogrel loading (300 mg). Patients in the cilostazol group were administered adjunctive cilostazol (100 mg twice a day) in place of clopidogrel loading. Patient characteristics, medications, and 30-day clinical outcomes were examined.
RESULTS: The mean duration of cilostazol administration in the cilostazol group was 6.2 ± 4.9 days from the time of primary coronary intervention. No significant difference was observed in major adverse cardiac events (cardiac death, definite stent thrombosis, and non-fatal myocardial infarction) between the loading group and the cilostazol group (9/100; 9.0 vs. 8/112; 7.1 %, p = 0.62). Definite stent thrombosis was observed for two patients in the loading group and one patient in the cilostazol group. The occurrence ratio of bleeding events did not differ significantly between the two groups (9.0 vs. 5.4 %, p = 0.30).
CONCLUSION: There was no significant difference in the incidence of major adverse cardiac events between temporary adjunctive cilostazol treatment and clopidogrel loading in ST-segment elevation acute myocardial infarction patients. Our findings suggest one potential of cilostazol.
Authors:
Akihito Tanaka; Hideki Ishii; Masaki Sakakibara; Satoshi Okumura; Yasushi Jinno; Koji Okada; Susumu Suzuki; Yosuke Inoue; Toyoaki Murohara
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-1-23
Journal Detail:
Title:  American journal of cardiovascular drugs : drugs, devices, and other interventions     Volume:  -     ISSN:  1179-187X     ISO Abbreviation:  Am J Cardiovasc Drugs     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2014-1-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100967755     Medline TA:  Am J Cardiovasc Drugs     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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