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- Title
A Meta-Analysis of Randomized Controlled Trials Appraising the Efficacy and Safety of Cilostazol after Coronary Artery Stent Implantation.
- Authors
Jae-Sik Jang; Han-Young Jin; Jeong-Sook Seo; Tae-Hyun Yang; Dae-Kyeong Kim; Dong-Soo Kim; Dong-Kie Kim; Sang-Hoon Seol; Doo-Il Kim; Kyoung-Im Cho; Bo-Hyun Kim; Yong Hyun Park; Hyung-Gon Je; Young-Hoon Jeong; Won-Jang Kim; Jong-Young Lee; Seung-Whan Lee
- Abstract
Objectives: To evaluate the impact of cilostazol on the angiographic and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) with stents and treated with aspirin and thienopyridine. Methods: A total of 11 randomized controlled trials including 8,525 patients comparing triple antiplatelet therapy (aspirin, thienopyridine and cilostazol) with standard dual antiplatelet therapy were included in the analysis. The primary end points were in-segment late loss and angiographic restenosis at angiographic follow-up. Secondary end points included mortality, stent thrombosis, target lesion revascularization (TLR) and major adverse cardiac events (MACE). Results: Triple antiplatelet therapy was associated with a significant reduction in late loss [weighted mean difference 0.14, 95% confidence interval (CI) 0.08-0.20; p <0.0011 and angiographic restenosis [odds ratio (OR) 0.58, 95% CI 0.48-0.71; p< 0.001]. Addition of cilostazol to dual antiplatelet therapy was associated with a significant reduction in TLR (OR 0.56,95% CI 0.41-0.77; p <0.001) and MACE (OR 0.72, 95% Cl 0.60-0.86; p < 0.001) with no differences in mortality (p = 0.29), stent thrombosis (p = 0.60) or bleeding episodes (p = 0.77). Conclusions: Cilostazol in addition to dual antiplatelet therapy appears to be effective in reducing the risk of restenosis and repeat revascularization after PCI without any significant benefits for mortality or stent thrombosis.
- Subjects
DRUG efficacy; CARDIOVASCULAR disease treatment; CARDIOVASCULAR diseases; PATIENTS; META-analysis; RANDOMIZED controlled trials; PLATELET aggregation inhibitors
- Publication
Cardiology, 2012, Vol 122, Issue 3, p133
- ISSN
0008-6312
- Publication type
Article
- DOI
10.1159/000339238