Use of Cilostazol, a Novel Antiplatelet Agent, in a Post-Palmaz-Schatz Stenting Regimen

• Published in: The American journal of cardiology Vol. 79; no. 11; pp. 1471 - 1474
• Main Authors: Ochiai, Masahiko, Isshiki, Takaaki, Takeshita, Satoshi, Eto, Koji, Toyoizumi, Hideki, Sato, Tomohide, Miyashita, Hideo
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.1997; Elsevier; Elsevier Limited
• Subjects: Adult; Aged; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Cardiovascular disease; Cilostazol; Coronary Angiography; Coronary Thrombosis - diagnostic imaging; Coronary Thrombosis - etiology; Coronary Thrombosis - prevention & control; Drug therapy; Female; Humans; Male; Medical procedures; Medical research; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Phosphodiesterase Inhibitors - adverse effects; Phosphodiesterase Inhibitors - therapeutic use; Platelet Aggregation Inhibitors - adverse effects; Platelet Aggregation Inhibitors - therapeutic use; Stents - adverse effects; Tetrazoles - adverse effects; Tetrazoles - therapeutic use; Treatment Outcome; Human; Endoprosthesis; Coronary artery; Instrumentation therapy; Cardiovascular disease; Cilostazol; Instrumental dilatation; Thrombosis; Antiplatelet agent; Vascular disease; Prevention; Restenosis; Chemotherapy; Treatment; Complication
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(97)00173-2

We evaluated the therapeutic efficacy of cilostazol, a novel potent inhibitor of phosphodiesterase, for the prevention of stent thrombosis following implantation of a Palmaz-Schatz stent guided by angiographic visual estimation alone in 71 patients with 84 lesions. Patients received 81 mg of aspirin 3 times daily and 100 mg of cilostazol twice daily after angiographic confirmation of optimal Palmaz-Schatz stent implantation. Of the 84 vessels stented, 65 (77%) were classified as type B2 or C lesions according to the modified American Heart Association/American College of Cardiology classification, and 51 (61%) were <3.0 mm in diameter. Multiple stents were used in 26 patients (31%). The final balloon inflation pressure was 18.3 ± 1.5 atm. The balloon-to-vessel ratio was 1.18 ± 0.16. No patient received heparin or warfarin after the procedure. There were no deaths, Q-wave myocardial infarctions, in- or out-of-hospital stent thrombosis, coronary bypass surgery, or serious side effects such as neutropenia and/or liver dysfunction during the 1-month follow-up period. These results indicate that cilostazol was a safe and effective antiplatelet agent with minimum side effects after Palmaz-Schatz stent implantation. We evaluated the usefulness of cilostazol, a novel antiplatelet agent, for the prevention of stent thrombosis. No deaths, Q-wave myocardial infarctions, stent thrombosis, or serious side effects such as neutropenia occurred during the 1-month follow-up period, which suggests cilostazol is a safe and effective antiplatelet agent after Palmaz-Schatz stent implantation.