Cilostazol or High-Dose Clopidogrel for Platelet Resistance?

In a small randomized trial, cilostazol outperformed high-dose clopidogrel according to various measures of platelet inhibition.

Residual platelet activity after clopidogrel administration is associated with adverse clinical outcomes in stent recipients. In this randomized study, investigators in Korea compared the effects of cilostazol (100 mg twice daily) with those of high-dose clopidogrel (150 mg daily) on platelet function in 60 patients with platelet resistance after stent implantation (22% of eligible patients). Platelet resistance was defined as high platelet reactivity 12 hours after administration of aspirin and a loading dose of clopidogrel, as measured by light transmission aggregometry.

Platelet function was reassessed 30 days after treatment assignment. The proportion of patients with high residual platelet reactivity was lower in the cilostazol group th…

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