Key result
Adding cilostazol to conventional AMI therapy shows no benefit for 6-month LVESV.
Why the study?
The impact of the positive chronotropic effect of cilostazol on left ventricular volume and function after acute myocardial infarction was evaluated due to limited data.
Does the addition of cilostazol to conventional antiplatelet therapy affect left ventricular remodeling or function in patients with acute myocardial infarction treated with primary stenting?
Cohort (n=56)
Does the addition of cilostazol to conventional antiplatelet therapy affect left ventricular remodeling or function in patients with acute myocardial infarction treated with primary stenting?
Mean Difference: -3
Absolute Event Rate: -10% vs -7.1%
p-value: p=0.60
The addition of cilostazol to conventional antiplatelet therapy after AMI does not adversely affect left ventricular remodeling or function at 6 months.
Cilostazol addition was not associated with adverse LV remodeling post-AMI; hypothesis-generating and requires randomized confirmation before any practice consideration.
BACKGROUND: Cilostazol, a phosphodiesterase inhibitor, is an antiplatelet agent with positive chronotropic effect, the impact of which on left ventricular (LV) volume and function in acute myocardial infarction (AMI) was evaluated in the present study. METHODS AND RESULTS: In 56 patients with AMI treated with primary coronary stenting, serial echocardiographic studies within 24 h and at 6 months were performed. Patients received a conventional antiplatelet regimen either without cilostazol (group 1, n=29) or with cilostazol (group 2, n=27). At 6 months, the difference in the change in heart rate between group 1 and group 2 was statistically significant (9.9 beats/min; p=0.04). However, changes in LV end-systolic volume (LVESV) (7.1+/-8.2 vs 10.0+/-21.7 ml, p=0.60), LV ejection fraction (EF) (8.2+/-9.9 vs 9.0+/-12.6%, p=0.85) and the ratio of early mitral inflow velocity to the mitral annular velocity (E/E') (0.6+/-3.7 vs -1.7+/-3.2) were not different between the 2 groups. Cardiac event rate was similar between the 2 groups. On multivariate regression analyses, cilostazol therapy had no significant influence on the changes in LVESV, LVEF or E/E'. CONCLUSIONS: In this study, the addition of cilostazol on conventional drug therapy had no adverse influence on LV remodeling or LV function after AMI.
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Lee et al. (2006) conducted a cohort in Acute Myocardial Infarction (n=56). Cilostazol vs. Conventional antiplatelet regimen without cilostazol was evaluated on Change in left ventricular end-systolic volume (LVESV) at 6 months (MD -3.0 ml, p=0.60). The addition of cilostazol to conventional drug therapy in patients with acute myocardial infarction had no significant influence on the change in left ventricular end-systolic volume at 6 months (MD -3.0 ml, p=0.60).
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