Cilostazol for prevention of thrombosis and restenosis after intracoronary stenting.
OBJECTIVE
To evaluate the potential use of cilostazol in intracoronary stenting.


METHODS
Clinical literature was accessed through MEDLINE (1966-March 2001). Key search terms included cilostazol, intracoronary stenting, and coronary angioplasty. Abstracts of clinical trials presented at major cardiology professional association meetings were also reviewed.


RESULTS
Intracoronary stent placement represents the fastest growing medical device implant. Complications of stent implantation include acute and subacute vessel closure, as well as late restenosis. Currently, antiplatelet agents are used for preventive therapy. Cilostazol is a vasodilating antiplatelet agent that reversibly inhibits platelet aggregation induced by many factors. In seven randomized trials comparing cilostazol with either aspirin or ticlopidine, cilostazol was found to be superior to aspirin and equivalent to ticlopidine in decreasing both cardiac events and rates of restenosis. In addition, cilostazol was found to be well tolerated, with no reports of adverse hematologic events.


CONCLUSIONS
Although further comparative trials are required, cilostazol appears to be a safe and effective alternative to clopidogrel and glycoprotein IIb/IIIa receptor antagonists following intracoronary stent implantation.
El-Beyrouty
C
C
Thomas Jefferson University Hospital, Philadelphia, PA 19104-4495, USA.
Spinler
S A
SA
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D000077407:Cilostazol; D003327:Coronary Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control*; D003328:Coronary Thrombosis / Q000517:prevention & control*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D015607:Stents; D013777:Tetrazoles / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005343:Fibrinolytic Agents; D013777:Tetrazoles; D000077407:Cilostazol; D001241:Aspirin