El uso de Cilostazol en la Intervención Coronaria Percutánea

Translated title of the contribution: Use of cilostazol in percutaneous coronary interventions

Kelly C. Rogers Dr., Jenna M. Faircloth, Shannon Finks

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate the addition of cilostazol to standard dual antiplatelet therapy (DAT) with aspirin and clopidogrel in patients receiving coronary stenting. DATA SOURCES: Relevant information was identified through a search of MEDLINE (1966-November 2011), International Pharmaceutical Abstracts (1960-2011), and Cochrane Databases (publications archived until November 2011) using the terms cilostazol, percutaneous coronary intervention, triple therapy, and antiplatelet agents. STUDY SELECTION AND DATA EXTRACTION: English-language prospective and retrospective studies, including registry data in adults, were eligible for inclusion if triple therapy with cilostazol was compared with DAT with aspirin and clopidogrel in patients undergoing percutaneous coronary intervention (PCI) with stenting. Article bibliographies were also reviewed. DATA SYNTHESIS: Cilostazol uniquely possesses antiproliferative properties in addition to its antiplatelet effects. Several prospective and retrospective clinical trials evaluated it as a third agent in standard antiplatelet regimens after PCI with both bare metal and drug-eluting stents. Both angiographic and clinical outcomes, including major adverse cardiac events (MACEs), have been improved with the addition of cilostazol to DAT in most trials, without increasing bleeding risk. Higher-risk patients, such as elderly individuals and patients with diabetes, long lesions, or small vessels, seem to benefit the most from triple therapy. Patients who are poor responders to clopidogrel also appear to benefit from the addition of cilostazol by improving platelet reactivity with standard DAT. CONCLUSIONS: Triple therapy with cilostazol has been shown to reduce MACEs by providing increased inhibition of platelet aggregation and reducing the rates of instent thrombosis compared to DAT without increasing the risk of bleeding complications. Further studies are needed to identify proper patient selection based on risk factors for the addition of cilostazol. Additionally, studies comparing cilostazol with newer antiplatelet therapies, such as prasugrel and ticagrelor, are needed.

Original languageSpanish
Pages (from-to)839-850
Number of pages12
JournalAnnals of Pharmacotherapy
Volume46
Issue number6
DOIs
StatePublished - Jun 1 2012

Fingerprint

Percutaneous Coronary Intervention
clopidogrel
Therapeutics
Aspirin
cilostazol
Hemorrhage
Drug-Eluting Stents
Platelet Aggregation Inhibitors
Bibliography
Platelet Aggregation
MEDLINE
Patient Selection
Registries
Publications
Thrombosis
Language
Blood Platelets
Retrospective Studies
Metals
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

El uso de Cilostazol en la Intervención Coronaria Percutánea. / Rogers Dr., Kelly C.; Faircloth, Jenna M.; Finks, Shannon.

In: Annals of Pharmacotherapy, Vol. 46, No. 6, 01.06.2012, p. 839-850.

Research output: Contribution to journalArticle

Rogers Dr., Kelly C. ; Faircloth, Jenna M. ; Finks, Shannon. / El uso de Cilostazol en la Intervención Coronaria Percutánea. In: Annals of Pharmacotherapy. 2012 ; Vol. 46, No. 6. pp. 839-850.
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abstract = "OBJECTIVE: To evaluate the addition of cilostazol to standard dual antiplatelet therapy (DAT) with aspirin and clopidogrel in patients receiving coronary stenting. DATA SOURCES: Relevant information was identified through a search of MEDLINE (1966-November 2011), International Pharmaceutical Abstracts (1960-2011), and Cochrane Databases (publications archived until November 2011) using the terms cilostazol, percutaneous coronary intervention, triple therapy, and antiplatelet agents. STUDY SELECTION AND DATA EXTRACTION: English-language prospective and retrospective studies, including registry data in adults, were eligible for inclusion if triple therapy with cilostazol was compared with DAT with aspirin and clopidogrel in patients undergoing percutaneous coronary intervention (PCI) with stenting. Article bibliographies were also reviewed. DATA SYNTHESIS: Cilostazol uniquely possesses antiproliferative properties in addition to its antiplatelet effects. Several prospective and retrospective clinical trials evaluated it as a third agent in standard antiplatelet regimens after PCI with both bare metal and drug-eluting stents. Both angiographic and clinical outcomes, including major adverse cardiac events (MACEs), have been improved with the addition of cilostazol to DAT in most trials, without increasing bleeding risk. Higher-risk patients, such as elderly individuals and patients with diabetes, long lesions, or small vessels, seem to benefit the most from triple therapy. Patients who are poor responders to clopidogrel also appear to benefit from the addition of cilostazol by improving platelet reactivity with standard DAT. CONCLUSIONS: Triple therapy with cilostazol has been shown to reduce MACEs by providing increased inhibition of platelet aggregation and reducing the rates of instent thrombosis compared to DAT without increasing the risk of bleeding complications. Further studies are needed to identify proper patient selection based on risk factors for the addition of cilostazol. Additionally, studies comparing cilostazol with newer antiplatelet therapies, such as prasugrel and ticagrelor, are needed.",
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