[Short-term outcomes of triple antiplatelet therapy after percutaneous coronary intervention].
OBJECTIVE
To evaluate short-term efficacy and safety of triple antiplatelet regimen (cilostazol combined with clopidogrel and aspirin) in patients who underwent percutaneous coronary intervention (PCI).


METHODS
From October 2001 to April 2005, a total of 3135 patients underwent PCI in the General Hospital of Shenyang Command, People's Liberation Army, of which 1103 were treated with cilostazol 100 mg twice a day for 6 months in addition to aspirin and clopidogrel for 3 - 12 months as triple antiplatelet therapy regimen (triple group) after PCI, and 2032 of which received aspirin and clopidogrel for 3 - 12 months as dual antiplatelet therapy regimen after PCI (control group). The data of the incidence rates of major adverse cardiac events (MACE), subacute in-stent thrombosis (SAT), and hemorrhage events within 30 days after PCI of the two groups were retrospectively analyzed.


RESULTS
The baseline clinical characteristics were comparable between these two groups. However, the proportions of the patients receiving stent implantation, with multivessel coronary artery diseases, and receiving PCI for unprotected left main trunk diseases of the triple group (91.3%, 68.3%, and 7.1% respectively) were all significantly higher than those of the control group (89.1%, 63.3%, and 4.6%, P < 0.05, P < 0.01, and P < 0.01). The proportion of patients with chronic total occlusions who received PCI in the triple group was 10.8%, significantly lower than that of the control group (13.4%, P < 0.05). No death occurred during procedure in both groups. The 30 d mortality and the rate of MACE with 30 days after PCI of the triple group were 0.4% and 1.3%, both significantly lower than those of the control group (1.6%, and 2.6%, both P < 0.05). However, there were no significant differences in the incidence rates of SAT and major hemorrhage events between these 2 groups (0.7% vs 1.0% and 0.3% vs. 0.2% respectively, both P > 0.05).


CONCLUSIONS
This novel triple antiplatelet regimen (aspirin and clopidogrel combined with cilostazol) for PCI patients is safe and more efficient than the dual antiplatelet therapy regimen (clopidogrel and aspirin) in reducing mortality and incidence of MACE in a short-term period.
Han
Ya-ling
YL
Cardiovascular Research Institute, Department of Cardiology, General Hospital of Shenyang Command, People's Liberation Army, Shenyang 110016, China. hanyal@mail.sy.ln.cn
Su
Qing-feng
QF
Li
Yi
Y
Wang
Shou-li
SL
Jing
Quan-min
QM
Ma
Ying-yan
YY
Wang
Zu-lu
ZL
Wang
Dong-mei
DM
Luan
Bo
B
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000627:therapeutic use; D000077407:Cilostazol; D000077144:Clopidogrel; D003327:Coronary Disease / Q000188:drug therapy* / Q000601:surgery; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011184:Postoperative Period; D012189:Retrospective Studies; D013777:Tetrazoles / Q000627:therapeutic use; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine; D001241:Aspirin