title: A randomized study assessing the effects of pretreatment with cilostazol on periprocedural myonecrosis after percutaneous coronary intervention.
abstract: OBJECTIVE
  It is unknown whether cilostazol pretreatment reduces postprocedural myonecrosis (PPMN). Cilostazol pretreatment reduces PPMN after percutaneous coronary intervention (PCI).
  
  
  METHODS
  A total of 120 patients with stable angina scheduled for elective PCI were randomly assigned to a 7-day pretreatment with Cilostazol (200 mg/day) or to a control group. Creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) levels were measured at baseline and at 6 and 24 hours after PCI. The primary end-point was the occurrence of PPMN, defined as any CK-MB elevation above the upper normal limit (UNL). Aspirin and clopidogrel were co-administered for 7 days before PCI, and resistance to these agents was then assayed using the VerifyNow System.
  
  
  RESULTS
  There was no difference in baseline characteristics between the final analyzable cilostazol (n=54) and the control group (n=56). Despite a significantly greater % inhibition of clopidogrel in the cilostazol group (39±23% versus 25±22%, p=0.003), the incidence of PPMN was similar between the cilostazol group (24%) and the control group (25%, p=1.000). The rate of CK-MB elevation at ≥3 times UNL was also similar between the two groups (6% versus 5%, p=0.583). The incidence of cTnI increase over the UNL or to 3 times the UNL was not different between the two groups. There was no significant difference in terms of the rate of adverse events during follow- up, although the cilostazol group showed a tendency to have a slightly higher incidence of entry site hematoma.
  
  
  CONCLUSIONS
  This trial demonstrated that adjunctive cilostazol pretreatment might not significantly reduce PPMN after elective PCI in patients with stable angina.
authors.affiliation: Cardiology Division, Cardiovascular Center of National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
authors.forename: Byeong-Keuk
authors.initials: BK
authors.lastname: Kim
authors.forename: Seung Jin
authors.initials: SJ
authors.lastname: Oh
authors.forename: Se-Jung
authors.initials: SJ
authors.lastname: Yoon
authors.forename: Dong Woon
authors.initials: DW
authors.lastname: Jeon
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Yang
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000188:drug therapy / Q000201:enzymology / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D000077407:Cilostazol; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006335:Heart Injuries / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D058987:Phosphodiesterase 3 Inhibitors / Q000008:administration & dosage*; D011446:Prospective Studies; D013777:Tetrazoles / Q000008:administration & dosage*
chemical_list: D058987:Phosphodiesterase 3 Inhibitors; D013777:Tetrazoles; D052279:Creatine Kinase, MB Form; D000077407:Cilostazol