Temporary adjunctive cilostazol vs clopidogrel loading for ST-segment elevation acute myocardial infarction.
BACKGROUND
Clopidogrel loading is a standard method to achieve rapid platelet inhibition and prevent thrombotic events. At the current time, little information is available to determine the effect of adjunctive cilostazol compared with clopidogrel loading.


METHODS
We retrospectively analyzed 212 patients undergoing primary percutaneous coronary intervention with drug-eluting stents for ST-segment elevation acute myocardial infarction. All patients were administered aspirin (100 mg once a day) and clopidogrel (75 mg once a day). The patients were divided into two groups according to the presence (loading group, n = 100) or absence (cilostazol group, n = 112) of clopidogrel loading (300 mg). Patients in the cilostazol group were administered adjunctive cilostazol (100 mg twice a day) in place of clopidogrel loading. Patient characteristics, medications, and 30-day clinical outcomes were examined.


RESULTS
The mean duration of cilostazol administration in the cilostazol group was 6.2 ± 4.9 days from the time of primary coronary intervention. No significant difference was observed in major adverse cardiac events (cardiac death, definite stent thrombosis, and non-fatal myocardial infarction) between the loading group and the cilostazol group (9/100; 9.0 vs. 8/112; 7.1%, p = 0.62). Definite stent thrombosis was observed for two patients in the loading group and one patient in the cilostazol group. The occurrence ratio of bleeding events did not differ significantly between the two groups (9.0 vs. 5.4%, p = 0.30).


CONCLUSIONS
There was no significant difference in the incidence of major adverse cardiac events between temporary adjunctive cilostazol treatment and clopidogrel loading in ST-segment elevation acute myocardial infarction patients. Our findings suggest one potential of cilostazol.
Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan, akihito17491194@gmail.com.
Akihito
A
Tanaka
Hideki
H
Ishii
Masaki
M
Sakakibara
Satoshi
S
Okumura
Yasushi
Y
Jinno
Koji
K
Okada
Susumu
S
Suzuki
Yosuke
Y
Inoue
Toyoaki
T
Murohara
D000208:Acute Disease; D000368:Aged; D000077407:Cilostazol; D000077144:Clopidogrel; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D013777:Tetrazoles / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine