What question did this study set out to answer?

The aim is to assess cilostazol's effectiveness and safety as an alternative antiplatelet therapy for patients who cannot tolerate aspirin.

March 26, 2026

The Efficacy and Safety of Cilostazol as an Alternative Antiplatelet Therapy After Coronary Stent Implantation in Patients With Aspirin Intolerance

Q: What does this research mean for the field?

Cilostazol significantly reduces major adverse cardiac events in aspirin-intolerant patients following percutaneous coronary intervention. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Cilostazol significantly reduced major adverse cardiac events (RR 0.71) in aspirin-intolerant patients following percutaneous coronary intervention.

Key Points

The aim is to assess cilostazol's effectiveness and safety as an alternative antiplatelet therapy for patients who cannot tolerate aspirin.
Reviewed prospective and retrospective studies on cilostazol therapy for ASA-intolerant patients
Utilized databases like PubMed, Google Scholar, and Cochrane
Employed fixed and random effect models for statistical analysis
Cilostazol significantly reduced major adverse cardiac events (P = 0.02, RR = 0.71)
Nonsignificant trend observed for myocardial infarction (P = 0.34, RR = 0.42)
Nonsignificant trend for major bleeding events (P = 0.71, RR = 0.65)

Structured PICO

Does cilostazol reduce major adverse cardiac events in patients undergoing percutaneous coronary intervention with aspirin intolerance?

Population

Patients undergoing percutaneous coronary intervention (PCI) with aspirin intolerance

Intervention

Cilostazol as an alternative antiplatelet therapy

Outcome

Incidence of major adverse cardiac events (MACE)composite

Cilostazol may be an effective alternative antiplatelet agent that reduces major adverse cardiac events in aspirin-intolerant patients undergoing PCI.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Aspirin (ASA) is commonly used in dual antiplatelet therapy (DAPT) of patients undergoing percutaneous coronary intervention. The pharmacologic management in the patient demographic with an ASA intolerance is poorly defined. This study aims to determine the efficacy and safety of the phosphodiesterase-3 inhibitor, cilostazol, as an alternative DAPT for ASA-intolerant patients. We used PubMed, Google Scholar, and Cochrane until January 2024 to identify all related prospective and retrospective studies evaluating cilostazol antiplatelet therapy in ASA-intolerant patients. Studies that did not include the target population were excluded. Fixed and random effect models with the Mantel-Haenszel statistical method were used to calculate P values, risk ratios, Z scores, and a 95% confidence interval on RevMan 7.14.0 software. Cilostazol use demonstrates a significant decrease in the incidence of major adverse cardiac events (P = 0.02) (relative risk RR = 0.71 0.53, 0.94). A nonsignificant trend for benefit was identified for incidence of myocardial infarction (P = 0.34) (RR = 0.42 0.07, 2.46) and major bleeding event (P = 0.71) (RR = 0.65 0.07, 6.37). The findings of this study suggest a potential benefit for the use of cilostazol in patients after percutaneous coronary intervention with aspirin intolerance.

Bookmark