Cilostazol Attenuates Spontaneous Microaggregation of Platelets in Type 2 Diabetic Patients With Insufficient Platelet Response to Aspirin

Prevention of cardiovascular disease is an important therapeutic goal in patients with type 2 diabetes mellitus (1). Although a low dose of aspirin is recommended for this purpose, some patients were resistant to aspirin (2). We previously reported that spontaneous microaggregation of platelets (SMAPs) formed under no stimulation with exogenous agonists were frequently observed in type 2 diabetic patients (3,4) and a considerable number of patients receiving aspirin still showed SMAP formation (4). The aim of the current study was to investigate whether a switch from aspirin to another antiplatelet drug could improve an insufficient platelet response to aspirin in diabetic patients. This was an open-label, single-arm, uncontrolled trial of antiplatelet treatment with 200 mg cilostazol daily (a phosphodiesterase III inhibitor) as an alternative to aspirin in 24 Japanese type 2 diabetic patients who persistently showed the inadequate SMAP formation despite treatment with …