Open AccessAdjunctive loading dose of cilostazol in preventing periprocedural myocardial infarction
Author(s) -
Xu LingXia,
Chen KangYin,
Liu Tong,
Zheng XinTian,
Jiao ZhanQuan,
Xu Yanmin,
Li Guangping
Publication year - 2016
Publication title -
cardiovascular therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.818
H-Index - 46
eISSN - 1755-5922
pISSN - 1755-5914
DOI - 10.1111/1755-5922.12192
Subject(s) - medicine , cilostazol , conventional pci , clopidogrel , aspirin , percutaneous coronary intervention , acute coronary syndrome , hazard ratio , myocardial infarction , cardiology , incidence (geometry) , confidence interval , physics , optics
Summary Introduction Periprocedural myocardial infarction ( PMI ) is a common complication of percutaneous coronary intervention ( PCI ). This study evaluated the safety and efficacy of adjunctive loading dose of cilostazol in preventing PMI in patients with acute coronary syndrome ( ACS ). Methods A total of 113 patients with ACS undergoing PCI were randomized to receive loading doses of dual (aspirin plus clopidogrel; DAPT group; n=57) or triple antiplatelet therapy (aspirin plus clopidogrel plus cilostazol; TAPT group; n=56). The loading and maintenance doses were 100 and 50 mg bid for cilostazol. Patients in the TAPT group received adjunctive cilostazol for 1 week. Cardiac biomarkers were measured before PCI , 8 and 24 hours after PCI to determine the incidence of PMI . Results There was no significant difference in the incidence of PMI between the TAPT and DAPT groups (32.1% vs 47.4%, P =.098). However, in the antiplatelet‐naïve subgroup, TAPT significantly lowered the incidence of PMI compared to DAPT (17.9% vs 42.9%, P =.042). In the antiplatelet‐treated subgroup, the incidences of PMI were comparable (46.4% vs 51.7%, P =.698). Multivariable logistic analysis showed that antiplatelet‐treated (vs antiplatelet‐naïve) (hazard ratio [ HR ]: 2.45; 95% confidence interval [ CI ]: 1.09–5.52; P =.030) subgroup was independently associated with PMI . However, TAPT (vs DAPT ) ( HR : 0.51; 95% CI : 0.23–1.14; P =.102) was not an independent protective factor of PMI . Conclusions The present single‐center, randomized study indicates that TAPT with adjunctive cilostazol was not associated with lower incidence of PCI ‐related PMI in patients with ACS . Further study with large study population is needed to get definite conclusions.