title: A meta-analysis of randomized controlled trials appraising the efficacy and safety of cilostazol after coronary artery stent implantation.
abstract: OBJECTIVE
  To evaluate the impact of cilostazol on the angiographic and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) with stents and treated with aspirin and thienopyridine.
  
  
  METHODS
  A total of 11 randomized controlled trials including 8,525 patients comparing triple antiplatelet therapy (aspirin, thienopyridine and cilostazol) with standard dual antiplatelet therapy were included in the analysis. The primary end points were in-segment late loss and angiographic restenosis at angiographic follow-up. Secondary end points included mortality, stent thrombosis, target lesion revascularization (TLR) and major adverse cardiac events (MACE).
  
  
  RESULTS
  Triple antiplatelet therapy was associated with a significant reduction in late loss [weighted mean difference 0.14, 95% confidence interval (CI) 0.08-0.20; p < 0.001] and angiographic restenosis [odds ratio (OR) 0.58, 95% CI 0.48-0.71; p < 0.001]. Addition of cilostazol to dual antiplatelet therapy was associated with a significant reduction in TLR (OR 0.56, 95% CI 0.41-0.77; p < 0.001) and MACE (OR 0.72, 95% CI 0.60-0.86; p < 0.001) with no differences in mortality (p = 0.29), stent thrombosis (p = 0.60) or bleeding episodes (p = 0.77).
  
  
  CONCLUSIONS
  Cilostazol in addition to dual antiplatelet therapy appears to be effective in reducing the risk of restenosis and repeat revascularization after PCI without any significant benefits for mortality or stent thrombosis.
authors: Busan Paik Hospital, University of Inje College of Medicine, Busan, Korea. jsjang@medimail.co.kr
authors: Jae-Sik
authors: JS
authors: Jang
authors: Han-Young
authors: HY
authors: Jin
authors: Jeong-Sook
authors: JS
authors: Seo
authors: Tae-Hyun
authors: TH
authors: Yang
authors: Dae-Kyeong
authors: DK
authors: Kim
authors: Dong-Soo
authors: DS
authors: Kim
authors: Dong-Kie
authors: DK
authors: Kim
authors: Sang-Hoon
authors: SH
authors: Seol
authors: Doo-Il
authors: DI
authors: Kim
authors: Kyoung-Im
authors: KI
authors: Cho
authors: Bo-Hyun
authors: BH
authors: Kim
authors: Yong Hyun
authors: YH
authors: Park
authors: Hyung-Gon
authors: HG
authors: Je
authors: Young-Hoon
authors: YH
authors: Jeong
authors: Won-Jang
authors: WJ
authors: Kim
authors: Jong-Young
authors: JY
authors: Lee
authors: Seung-Whan
authors: SW
authors: Lee
mesh_terms: D001241:Aspirin / Q000627:therapeutic use; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D000077407:Cilostazol; D000077144:Clopidogrel; D003131:Combined Modality Therapy; D023903:Coronary Restenosis / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D005260:Female; D006083:Graft Occlusion, Vascular / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D015607:Stents; D013777:Tetrazoles / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D011725:Pyridines; D013777:Tetrazoles; C446540:thienopyridine; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine; D001241:Aspirin