Cytochrome 2C19 Polymorphism and Response to Adjunctive Cilostazol Versus High Maintenance-Dose Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention
Key result
Among CYP2C19 mutant allele carriers undergoing PCI, adjunctive cilostazol achieved greater absolute change in maximal platelet aggregation compared to high-dose clopidogrel (25.8% vs 11.1%, P<0.001).
Why the study?
Does adjunctive cilostazol improve platelet inhibition compared to high maintenance-dose clopidogrel in high-risk patients undergoing elective PCI, irrespective of CYP2C19 genotyping?
Population
134 high-risk patients undergoing elective percutaneous coronary intervention, genotyped for CYP2C19 *1, *2…
Comparison
Adjunctive cilostazol 100 mg twice daily vs High maintenance-dose clopidogrel 150 mg daily
Design
RCT, randomly assigned
Follow-up
30-day
Authors
Discussion
Loading...
Member takes
Implication
Supports cilostazol addition for platelet inhibition in CYP2C19 carriers post-PCI; extends RCT evidence on genotype-guided antiplatelet response.
Study Design
Type
RCT (n=134)
Randomization
randomly assigned
Structured PICO
Does adjunctive cilostazol improve platelet inhibition compared to high maintenance-dose clopidogrel in high-risk patients undergoing elective PCI, irrespective of CYP2C19 genotyping?
P
Population
134 high-risk patients undergoing elective percutaneous coronary intervention, followed for 30 days.
I
Intervention
Adjunctive cilostazol 100 mg twice daily (triple therapy)
C
Comparator
High maintenance-dose clopidogrel 150 mg daily
O
Outcome
Absolute change in maximal platelet aggregation (ΔAgg(max)) according to CYP2C19 genotyping at 30-day follow-upsurrogate
Main Result
Absolute Event Rate: 25.8% vs 11.1%
p-value: p=<0.001
Adjunctive cilostazol achieves greater platelet inhibition than high-dose clopidogrel in PCI patients who are carriers of the CYP2C19 loss-of-function allele.
Cite This Study
Hwang et al. (2010) conducted an RCT in high-risk patients undergoing elective percutaneous coronary intervention (n=134). Adjunctive cilostazol vs. High maintenance-dose clopidogrel (150 mg daily) was evaluated on Absolute change in maximal platelet aggregation (ΔAgg(max)) according to CYP2C19 genotyping (p=<0.001). Among CYP2C19 mutant allele carriers undergoing PCI, adjunctive cilostazol achieved greater absolute change in maximal platelet aggregation compared to high-dose clopidogrel (25.8% vs 11.1%, P<0.001).