Effect of cilostazol on in-stent neointimal hyperplasia after coronary artery stenting: a quantative coronary angiography and volumetric intravascular ultrasound study.
BACKGROUND
This study was designed to investigate the efficacy of cilostazol on the prevention of in-stent neointimal hyperplasia as measured by both quantitative coronary angiography (CAG) and volumetric intravascular ultrasound (IVUS).


RESULTS
Fifty-nine patients (39 men, age 62 years) undergoing elective coronary stenting were randomly assigned to receive aspirin plus clopidogrel or ticlopidine (Group I, n=28, 30 lesions) or aspirin plus clopidogrel or ticlopidine plus cilostazol (Group II, n=31, 35 lesions). CAG and IVUS were performed and repeated at 6 months to assess the primary endpoints of minimal luminal diameter (MLD) and in-stent neointimal hyperplasia volume. Follow-up CAG was performed on all patients and follow-up IVUS study was available for 50 lesions in 48 patients (24 lesions in Group I, 26 in Group II). There were no significant differences in the baseline angiographic data between the 2 groups. At 6 months follow-up, in-stent MLD was 1.90+/-0.76 mm in Group I and 2.41+/-0.85 mm in Group II (p=0.006). Volumetric IVUS at 6 months demonstrated that in-stent intimal hyperplasia volume per stent length was 2.2+/-1.4 mm3/mm in Group I and 1.0+/-0.5 mm3/mm in Group II (p=0.001).


CONCLUSIONS
Triple antiplatelet therapy including cilostazol seems to be more effective at preventing in-stent neointimal hyperplasia than a dual antiplatelet regimen.
Min
Pil-Ki
PK
Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Jung
Jae-Hun
JH
Ko
Young-Guk
YG
Choi
Donghoon
D
Jang
Yangsoo
Y
Shim
Won-Heum
WH
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D000077407:Cilostazol; D000077144:Clopidogrel; D017023:Coronary Angiography; D003327:Coronary Disease / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects*; D013777:Tetrazoles / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology*; D018084:Ultrasonography, Interventional
D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine; D001241:Aspirin