Effects of cilostazol treatment on angiographic restenosis after coronary stent placement

Background and Objectives:Cilostazol is a potent antiplatelet agent with antiproliferative properties. Few data are available about the effect of cilostazol on post-stenting restenosis. The aim of this study was to evaluate the impact of cilostazol on post-stenting restenosis. Materials and Method:Four hundred and nine patients (494 lesions) scheduled for elective stenting were randomized to receive aspirin plus ticlopidine (group A, n=201, 240 lesions) or aspirin plus cilostazol (group B, n=208, 254 lesions), starting 2 days before stenting. Ticlopidine was given for 1 month and cilostazol for 6 months. Follow-up angiography was performed at 6 months, and clinical evaluation at regular intervals. Results:Baseline characteristics were similar between the two groups. Procedural success rate was 99.6% in group A and 100% in group B. There were no cases of stent thrombosis after stenting. Angiographic follow-up was performed in 380 of the 494 eligible lesions and angiographic restenosis rate was 27% in group A, and 22.9% in group B (p=NS). However, diffuse type in-stent restenosis was more common in group A than in group B (54.2% vs 26.8%, respectively, p<0.05). In diabetic patients, angiographic restenosis rate was 50% in group A and 21.7% in group B (p<0.05). Clinical events during the follow-up did not differ between the two groups. Conclusion:The combination therapy with aspirin plus cilostazol seems to be an effective antithrombotic regimen with comparable results to aspirin plus ticlopidine, but it does not reduce the overall angiographic restenosis rate after elective coronary stenting. (Korean Circulation J 2000;30(12):1495-1500)