Short-term efficacy of triple antiplatelet therapy in patients with ischemic cerebral vascular disease after percutaneous coronary intervention

Objective To evaluate short-term efficacy and safety of triple antiplatelet regimen (cilostazol combined with clopidogrel and aspirin) in treatment of patients with coronary heart disease (CHD) concomitant with ischemic cerebral vascular disease (ICVD) history after percutaneous coronary intervention (PCI) . Methods A total of 216 PCI patients with ICVD history in this hospital were analyzed retrospectively. Of them, 80 were treated with cilostazol 100 mg twice a day in addition to aspirin and clopidogrel as triple antiplatelet therapy regimen (triple group) after PCI, and 136 received aspirin and clopidogrel as dual antiplatelet therapy regimen after PCI (control group) .The data of the incidences of major adverse cardiac and cerebral vascular events (MACCE), subacute in-stent thrombosis (SAT), and hemorrhage events within 30 days after PCI of the two groups were analyzed. Results The baseline clinical characteristics and the immediate outcomes of PCI were similar in patients between the two groups, with no death occurred during the procedure in both groups. The mortality and the rates of stroke and MACCE within 30 days after PCI in the triple group were significantly lower than those in the control group ( P 0.05, P 0.01). However, there were no significant differences in the incidence rates of SAT, major hemorrhage events and cerebral hemorrhage between the two groups. Conclusion This novel triple antiplatelet regimen (aspirin and clopidogrel combined with eilostazol) used for PCI patients with ICVD history does not increase the incidence of cerebral hemorrhage and can reduce mortality, incidences of MACCE and stroke remarkably during 30-day observation period.