title: The effectiveness and safety of triple-antiplatelet treatment based on cilostazol for patients receiving percutaneous coronary intervention: a meta-analysis.
abstract: The combination of cilostazol, aspirin, and clopidogrel (triple therapy) after percutaneous coronary intervention has been considered as an alternative therapy. We performed a meta-analysis based on 8 randomized controlled trials with a total of 3332 patients to compare the effectiveness and safety of this triple therapy with traditional dual therapy (aspirin and clopidogrel). Our findings suggested that the triple therapy is more effective than dual therapy in preventing restenosis (odds ratio [OR]: 0.52, 95% confidence interval [CI]: 0.40-0.66, P < 0.00001), maintaining minimal lumen diameter (OR: 0.15, 95% CI: 0.10-0.20, P < 0.00001), and avoiding target-vessel revascularization (OR: 0.62, 95% CI: 0.47-0.82, P = 0.001). There is also no significant difference in major adverse cardiac and cerebrovascular events between the 2 therapies, except the smaller occurrence rate of target-lesion revascularization in the triple-therapy group (OR: 0.42, 95% CI: 0.26-0.69, P = 0.0005). However, the triple therapy is associated with a higher level of adverse drug events, including rash (OR: 2.45, 95% CI: 1.41-4.23, P = 0.001), gastrointestinal disorders (OR: 2.59, 95% CI: 1.26-5.30, P = 0.009), and drug discontinuation (OR: 3.80, 95% CI: 1.59-9.10, P = 0.003), but it has no difference in bleeding compared with the dual therapy (OR: 1.05, 95% CI: 0.71-1.55, P = 0.80).
authors.affiliation: State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.forename: Shijie
authors.initials: S
authors.lastname: Zhou
authors.forename: Rui
authors.initials: R
authors.lastname: Zhou
authors.forename: Gan
authors.initials: G
authors.lastname: Liu
authors.forename: Ping
authors.initials: P
authors.lastname: Tang
authors.forename: Jing
authors.initials: J
authors.lastname: He
authors.forename: Cong
authors.initials: C
authors.lastname: Ma
authors.forename: Yi
authors.initials: Y
authors.lastname: He
authors.forename: Jinliang
authors.initials: J
authors.lastname: Yang
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use*; D000077407:Cilostazol; D000077144:Clopidogrel; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000628:therapy; D023903:Coronary Restenosis / Q000517:prevention & control; D004359:Drug Therapy, Combination; D006801:Humans; D016017:Odds Ratio; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D013777:Tetrazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine; D001241:Aspirin