Korean Circ J.  2007 Jul;37(7):304-311. 10.4070/kcj.2007.37.7.304.

Effects of Cilostazol on the Drug-Eluting Stent in Native Coronary Arteries

• Kim SM
• Kim DI
• Cho HJ
• Seol SH
• Kim DK
• Yang TH
• Kim DS

• KMID: 2227057
• DOI: http://doi.org/10.4070/kcj.2007.37.7.304

Abstract

BACKGROUND AND OBJECTIVES: Cilostazol is an antiplatelet drug with antiproliferative properties when administered after coronary bare metal stent implantation. However, its effect on clinical and angiographic outcomes after sirolimus-eluting stent (SES) implantation in native coronary arteries has not been established.
SUBJECTS AND METHODS
Two hundred patients who had undergone successful SES implantation were randomly assigned to receive, in addition to aspirin, 75 mg clopidogrel daily or 100 mg cilostazol twice daily after one month of triple oral therapy (aspirin, clopidogrel, and cilostazol). The medications were continued until the follow-up coronary angiography, which was performed after six months.
RESULTS
There were no significant differences in the minimal luminal diameters before and immediately after the coronary intervention, and at the follow-up angiography. The late loss of minimal luminal diameter was 0.26+/-0.40 mm in the cilostazol group and 0.28+/-0.41 mm in the clopidogrel group (p=0.773). Other quantitative coronary angiography variables were also similar in the two groups. Restenosis, determined by quantitative coronary angiography at six months and defined as > or =30% narrowing, occurred in 11.4% of the clopidogrel group and 8.7% of the cilostazol group (p=0.478). However, in-stent restenosis was focal (100% vs 23.1% in the clopidogrel group, p<0.001), and shorter in the cilostazol group (6.26+/-2.42 vs 14.5+/-6.55 mm, p=0.001).
CONCLUSION
Cilostazol was not inferior to clopidogrel in terms of clinical anti-coagulation effect, and had an antiproliferative effect in native coronary arteries after SES implantation.

Keyword

Cilostazol; Clopidogrel; Sirolimus; Stents; Coronary restenosis

MeSH Terms

Angiography
Aspirin
Coronary Angiography
Coronary Restenosis
Coronary Vessels*
Drug-Eluting Stents*
Follow-Up Studies
Humans
Phenobarbital
Sirolimus
Stents
Aspirin
Phenobarbital
Sirolimus

Figure

• 

  Fig. 1 Cumulative distribution curves for the minimal luminal diameter (MLD) of the target coronary lesions at pre-intervention (closed triangles), post-intervention (closed squares), and follow-up coronary angiography (open circles) for the clopidogrel and cilostazol treatment groups.

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