Effects of cilostazol on late lumen loss and repeat revascularization after Palmaz-Schatz coronary stent implantation

Citation
K. Kozuma et al., Effects of cilostazol on late lumen loss and repeat revascularization after Palmaz-Schatz coronary stent implantation, AM HEART J, 141(1), 2001, pp. 124-130
Citations number
35
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
AMERICAN HEART JOURNAL
ISSN journal
0002-8703 → ACNP
Volume
141
Issue
1
Year of publication
2001
Pages
124 - 130
Database
ISI
SICI code
0002-8703(200101)141:1<124:EOCOLL>2.0.ZU;2-Z
Abstract
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 r. 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 tion.