Antiplatelet treatment with cilostazol after stent implantation

doi:10.1136/hrt.80.4.393

Heart 1998;80:393-396; doi:10.1136/hrt.80.4.393

Heart 1998;80:393-396 ( October )

Preliminary observations

Antiplatelet treatment with cilostazol after stent implantation Y Yoshitomi,^a S Kojima,^b T Sugi,^a M Yano,^a Y Matsumoto,^a M Kuramochi^a

^a Division of Cardiology, Tohsei National Hospital, 762-1 Nagasawa, Shimizu-cho, Suntoh-gun, Shizuoka 411, Japan, ^b Department of Clinical Research, Tohsei National Hospital

Correspondence to: Dr Yoshitomi.

Accepted for publication 8 June 1998

Objectives $---$ To evaluate the efficacy of cilostazol, a new synthetic inhibitor of phosphodiesterase, in preventing stent thrombosis aftersuccessfulimplantation.
Design $---$ Preliminary prospectivestudy.
Setting $---$ A single coronary care unit inJapan.
Patients $---$ Elective, bailout, or primary stents were implanted in 85 consecutive patients with 93 lesions. Primary stent implantationwas performed in 18 patients with acute myocardial infarction.Patients received 200 mg cilostazol and 243 mg aspirin afterstenting.
Main outcome measures $---$ Stent thrombosis, major and minor complications, and side effects were assessed in the six months afterstenting.
Results $---$ Gianturco-Roubin stents were implanted in 37 lesions, Wiktor stents in 55, and Palmaz-Schatz stents in 27. Multiple stentswere used in 26 lesions. There was no mortality, stent thrombosisrelated Q wave myocardial infarction, emergency bypass surgery,repeat intervention, or vascular complications in the six monthsof follow up. Acute or subacute closure did not occur after stenting.There were no serious side effects such as leucopenia and/or abnormalliver function for three months. Cilostazol was withdrawn in onepatient because of skin rash. Patients who underwent primary stentinghad no clinical events, such as acute or subacute thrombosis,or sideeffects.
Conclusions $---$ Cilostazol is an effective antiplatelet agent with minimum side effects after elective, bailout, or primary stentimplantation.

Keywords: antiplatelet treatment; stents; stent thrombosis; cilostazol

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