Multicenter randomized trial of 3-month cilostazol use in addition to dual antiplatelet therapy after biolimus-eluting stent implantation for long or multivessel coronary artery disease.

Abstract

BACKGROUND:

There are conflicting data on the use of cilostazol as triple antiplatelet therapy (TAPT) for improving clinical outcomes after drug-eluting stent implantation. We aimed to evaluate whether 3-month use of cilostazol in addition to dual antiplatelet therapy (DAPT) improved clinical outcomes in patients with long or multivessel coronary artery disease (CAD) after biolimus-eluting stent (BES) implantation.

METHODS:

Patients (n = 630) who had been successfully treated with BES implantation for lesions with ≥28 mm in stent length or ≥2 stents for different coronary arteries were enrolled in this prospective randomized multicenter trial. All patients were randomly assigned to receive either DAPT (aspirin and clopidogrel for 12 months, n = 314) or TAPT (DAPT plus 3-month cilostazol use, n = 316). The primary end point was a device-oriented composite consisting of cardiac death, myocardial infarction (not clearly attributable to a nontarget vessel), and ischemia-driven target lesion revascularization at 1-year follow-up.

RESULTS:

A total of 314 patients in DAPT and 308 patients in TAPT were analyzed. Multivessel CAD was present in 65.7% of patients. Stents ≥28 mm in length were implanted in 58.1% of lesions. There were no significant differences in baseline and angiographic characteristics between the 2 groups. The primary end point was similar between the 2 groups (2.3% in DAPT vs 1.9% in TAPT, log-rank P = .799).

CONCLUSIONS:

In patients treated with BES implantation for long or multivessel CAD, 3 months of cilostazol use in addition to DAPT did not improve clinical outcome at 1-year follow-up.

• Authors: Young Jin Youn, Jun-Won Lee, Sung Gyun Ahn, Seung-Hwan Lee, Hyunmin Choi, Cheol Woong Yu, Young Joon Hong, Hyuck Moon Kwon, Myeong-Ki Hong, Yangsoo Jang, Junghan Yoon
• Journal: American heart journal (Am Heart J) Vol. 167 Issue 2 Pg. 241-248.e1 (Feb 2014) ISSN: 1097-6744 [Electronic] United States
• PMID: 24439986 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: © 2014.

Chemical References

• Immunosuppressive Agents
• Platelet Aggregation Inhibitors
• Tetrazoles
• Clopidogrel
• Cilostazol
• Ticlopidine
• umirolimus
• Sirolimus

Topics

• Aged
• Cilostazol
• Clopidogrel
• Coronary Angiography
• Coronary Artery Disease (diagnostic imaging, therapy)
• Coronary Restenosis (prevention & control)
• Dose-Response Relationship, Drug
• Drug Therapy, Combination
• Drug-Eluting Stents
• Female
• Follow-Up Studies
• Humans
• Immunosuppressive Agents (pharmacology)
• Male
• Middle Aged
• Platelet Aggregation Inhibitors (administration & dosage)
• Prospective Studies
• Sirolimus (analogs & derivatives, pharmacology)
• Tetrazoles (administration & dosage)
• Ticlopidine (administration & dosage, analogs & derivatives)
• Time Factors
• Treatment Outcome