Cilostazol Fails to Reduce Cardiovascular Events After Drug-Eluting Stenting

In a randomized trial, adding cilostazol to dual antiplatelet therapy had no significant effect, but elevated residual platelet activity was independently associated with adverse outcomes.

In previous studies, adding cilostazol, a phosphodiesterase III inhibitor, to standard dual antiplatelet therapy (DAT; aspirin and clopidogrel) reduced rates of stent thrombosis (JW Cardiol Dec 16 2005) and restenosis. In this Korean, multicenter, open-label, randomized trial, 915 drug-eluting stent (DES) recipients received DAT with or without cilostazol.

Baseline characteristics were similar in the two groups, but platelet reactivity, as assessed by the VerifyNow assay, was significantly lower in cilostazol recipients than in DAT-only recipients (P2Y₁₂ reaction units [PRU], 207 vs. 232 at discharge; 211 vs. 256 at 6 months). Rates of clinical outcomes — death, myocardial infarction (MI), ischemic stroke, target lesion revascularization, an…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI