A Meta-Analysis of Randomized Controlled Trials Appraising the Efficacy and Safety of Cilostazol after Coronary Artery Stent Implantation

作者：Jang Jae Sik^*; Jin Han Young; Seo Jeong Sook; Yang Tae Hyun; Kim Dae Kyeong; Kim Dong Soo; Kim Dong Kie; Seol Sang Hoon; Kim Doo Il; Cho Kyoung Im; Kim Bo Hyun; Park Yong Hyun; Je Hyung Gon; Jeong Young Hoon; Kim Won Jang; Lee Jong Young; Lee Seung Whan

来源：Cardiology, 2012, 122(3): 133-143.

DOI：10.1159/000339238

• Antiplatelet agents
• Coronary artery disease
• Percutaneous coronary intervention

Objectives: To evaluate the impact of cilostazol on the angiographic and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) with stents and treated with aspirin and thienopyridine. Methods: A total of 11 randomized controlled trials including 8,525 patients comparing triple antiplatelet therapy (aspirin, thienopyridine and cilostazol) with standard dual antiplatelet therapy were included in the analysis. The primary end points were in-segment late loss and angiographic restenosis at angiographic follow-up. Secondary end points included mortality, stent thrombosis, target lesion revascularization (TLR) and major adverse cardiac events (MACE). Results: Triple antiplatelet therapy was associated with a significant reduction in late loss [weighted mean difference 0.14, 95% confidence interval (CI) 0.08-0.20; p %26lt; 0.001] and angiographic restenosis [odds ratio (OR) 0.58, 95% CI 0.48-0.71; p %26lt; 0.001]. Addition of cilostazol to dual antiplatelet therapy was associated with a significant reduction in TLR (OR 0.56, 95% CI 0.41-0.77; p %26lt; 0.001) and MACE (OR 0.72, 95% CI 0.60-0.86; p %26lt; 0.001) with no differences in mortality (p = 0.29), stent thrombosis (p = 0.60) or bleeding episodes (p = 0.77). Conclusions: Cilostazol in addition to dual antiplatelet therapy appears to be effective in reducing the risk of restenosis and repeat revascularization after PCI without any significant benefits for mortality or stent thrombosis.

• 出版日期2012