Background Cilostazol is an antiplatelet agent that increases the intracell
ular concentration of cyclic adenosine monophosphate by inhibiting phosphod
iesterase III; it has been shown to reduce neointimal hyperplasia in animal
balloon injury models.
Methods One hundred thirty patients who underwent elective stenting (Parmaz
-Schatz stent) were randomly assigned to cilostazol treatment 200 mg/d (n =
65) or to ticlopidine treatment 200 mg/d (n = 65), Angiographic follow-up
was performed at 6 months, and clinical follow-up was continued up to 1 yea
Results One sudden death and one myocardial infarction resulting from subac
ute occlusion were observed in the ticlopidine group. Drug adverse effects
were observed in 3 patients in the cilostazol group, as opposed to 6 patien
ts in the ticlopidine group. In the intention-to-treat analysis, 56 patient
s (61 lesions) in the cilostazol group and 58 patients (58 lesions) in the
ticlopidine group were assessed with quantitative coronary angiography, Lat
e loss in the cilostazol group was smaller (0.58 +/- 0.52 mm vs 1.09 +/- 0.
65 mm, P < .0001) than in the ticlopidine group. The restenosis rate was lo
wer in the cilostazol group than in the ticlopidine group (16% vs 33%, P =
.044). The target vessel revascularization rate at 1 year was 23% in the ci
lostazol group and 42% in the ticlopidine group (P = .03).
Conclusions The results of this study suggest that cilostazol may be a safe
medication that is effective in preventing restenosis after stent implanta