What question did this study set out to answer?

To determine whether cilostazol suppresses intimal proliferation and reduces arterial renarrowing in patients following coronary stent implantation.

October 26, 2005Circulation

Coronary Stent Restenosis in Patients Treated With Cilostazol

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Why the study?

Does cilostazol reduce angiographic restenosis in patients after successful coronary stent implantation?

Population

705 patients who had successful coronary stent implantation in native coronary arteries

Comparison

Cilostazol 100 mg oral twice daily for 6 months… vs Matching placebo for 6 months, added to aspirin…

Design

RCT, randomized, double-blind, placebo-controlled

Follow-up

6 months

Authors

JDJohn S. Douglas DHDavid R. Holmes DKDean J. Kereiakes

Discussion

Member takes

Overview

Supports adding cilostazol to dual antiplatelet therapy after stenting to reduce restenosis; confirms benefit in diabetics and small vessels.

Key Points

To determine whether cilostazol suppresses intimal proliferation and reduces arterial renarrowing in patients following coronary stent implantation.
Randomized, double-blind, placebo-controlled trial assigning 705 patients with successful coronary stent implantation to receive cilostazol 100 mg twice daily or placebo for 6 months.
All patients received baseline aspirin therapy combined with clopidogrel 75 mg daily for the first 30 days.
Vascular outcomes were evaluated at 6-month follow-up using quantitative coronary angiography.
Binary restenosis (≥50% narrowing) occurred in 22.0% of patients in the cilostazol group compared with 34.5% in the placebo group (P=0.002), conferring a 36% relative risk reduction.
Minimal luminal diameter at 6 months was significantly larger in the cilostazol cohort than in the placebo cohort (1.77 mm vs. 1.62 mm, P=0.01).
Restenosis was significantly reduced with cilostazol in diabetic patients (17.7% vs. 37.7%, P=0.01) and small vessels (23.6% vs. 35.2%, P=0.02), without differences in bleeding, myocardial infarction, or death.

Structured PICO

Does cilostazol reduce angiographic restenosis in patients after successful coronary stent implantation?

Population

705 patients who had successful coronary stent implantation in native coronary arteries

Intervention

Cilostazol 100 mg oral twice daily for 6 months, added to aspirin and 30 days of clopidogrel 75 mg daily

Comparator

Matching placebo for 6 months, added to aspirin and 30 days of clopidogrel 75 mg daily

Outcome

Restenosis (minimal luminal diameter and binary restenosis defined as >=50% narrowing) determined by quantitative coronary angiography at 6 monthssurrogate

The addition of cilostazol to standard antiplatelet therapy for 6 months significantly reduces angiographic restenosis after coronary stent implantation, including in high-risk subgroups such as patients with diabetes.

Cite This Study

Douglas et al. (2005) studied this question.

synapsesocial.com/papers/6a73905420644e164b4e618f https://doi.org/10.1161/circulationaha.104.530097

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October 26, 2005Circulation

Coronary Stent Restenosis in Patients Treated With Cilostazol

View Full Paper

Ask AI

Bookmark

Why the study?

Does cilostazol reduce angiographic restenosis in patients after successful coronary stent implantation?

Population

705 patients who had successful coronary stent implantation in native coronary arteries

Comparison

Cilostazol 100 mg oral twice daily for 6 months… vs Matching placebo for 6 months, added to aspirin…

Design

RCT, randomized, double-blind, placebo-controlled

Follow-up

6 months

Authors

JDJohn S. Douglas DHDavid R. Holmes DKDean J. Kereiakes

Discussion

Member takes

Overview

Supports adding cilostazol to dual antiplatelet therapy after stenting to reduce restenosis; confirms benefit in diabetics and small vessels.

Key Points

To determine whether cilostazol suppresses intimal proliferation and reduces arterial renarrowing in patients following coronary stent implantation.
Randomized, double-blind, placebo-controlled trial assigning 705 patients with successful coronary stent implantation to receive cilostazol 100 mg twice daily or placebo for 6 months.
All patients received baseline aspirin therapy combined with clopidogrel 75 mg daily for the first 30 days.
Vascular outcomes were evaluated at 6-month follow-up using quantitative coronary angiography.
Binary restenosis (≥50% narrowing) occurred in 22.0% of patients in the cilostazol group compared with 34.5% in the placebo group (P=0.002), conferring a 36% relative risk reduction.
Minimal luminal diameter at 6 months was significantly larger in the cilostazol cohort than in the placebo cohort (1.77 mm vs. 1.62 mm, P=0.01).
Restenosis was significantly reduced with cilostazol in diabetic patients (17.7% vs. 37.7%, P=0.01) and small vessels (23.6% vs. 35.2%, P=0.02), without differences in bleeding, myocardial infarction, or death.

Structured PICO

Does cilostazol reduce angiographic restenosis in patients after successful coronary stent implantation?

Population

705 patients who had successful coronary stent implantation in native coronary arteries

Intervention

Cilostazol 100 mg oral twice daily for 6 months, added to aspirin and 30 days of clopidogrel 75 mg daily

Comparator

Matching placebo for 6 months, added to aspirin and 30 days of clopidogrel 75 mg daily

Outcome

Restenosis (minimal luminal diameter and binary restenosis defined as >=50% narrowing) determined by quantitative coronary angiography at 6 monthssurrogate

Cite This Study

Douglas et al. (2005) studied this question.

synapsesocial.com/papers/6a73905420644e164b4e618f https://doi.org/10.1161/circulationaha.104.530097

Also Consider

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