A randomized study assessing the impact of cilostazol on platelet function profiles in patients with diabetes mellitus and coronary artery disease on dual antiplatelet therapy: results of the OPTIMUS-2 study
Why the study?
Does adjunctive cilostazol improve platelet P2Y(12) inhibition in patients with type 2 diabetes mellitus and coronary artery disease on dual antiplatelet therapy?
Population
25 patients with type 2 diabetes mellitus and coronary artery disease on dual antiplatelet therapy
Comparison
Cilostazol 100 mg twice daily for 14 days added… vs Placebo twice daily for 14 days added to…
Design
RCT, randomized, cross-over, double-blind, double-dummy, placebo-controlled
Follow-up
14 days per treatment period
Authors
Discussion
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Implication
Cilostazol augments P2Y12 inhibition in T2DM patients on DAPT; extends RCT evidence for adjunctive antiplatelet effects in this population.
Key Points
- This study aims to evaluate the effect of cilostazol on platelet function in patients with type 2 diabetes mellitus under dual antiplatelet therapy.
- Prospective, double-blind, placebo-controlled, randomized, cross-over design
- 25 patients with type 2 diabetes mellitus assigned to cilostazol or placebo for 14 days
- Platelet function evaluated at baseline, post-14 days, and after treatment cross-over
- P2Y(12) reactivity index significantly lower with cilostazol (36.3% vs. 59.9%; P=0.0002)
- Enhanced inhibition of platelet P2Y(12) signaling with cilostazol across functional tests
- Five patients discontinued treatment due to side effects.
Structured PICO
Does adjunctive cilostazol improve platelet P2Y(12) inhibition in patients with type 2 diabetes mellitus and coronary artery disease on dual antiplatelet therapy?
P
Population
25 patients with type 2 diabetes mellitus (T2DM) and coronary artery disease on dual antiplatelet therapy (aspirin and clopidogrel)
I
Intervention
Cilostazol 100 mg twice daily for 14 days added to standard aspirin and clopidogrel
C
Comparator
Placebo twice daily for 14 days added to standard aspirin and clopidogrel
O
Outcome
P2Y(12) reactivity index, determined through flow cytometric assessment of the phosphorylation status of the vasodilator-stimulated phosphoproteinsurrogate
Adjunctive treatment with cilostazol in T2DM patients on standard dual antiplatelet therapy significantly enhances inhibition of platelet P2Y(12) signalling.
Cite This Study
Angiolillo et al. (2008) studied this question.