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Int Heart J. 2017;58(6):853-860.

The Effect of Cilostazol on the Angiographic Outcome of Drug-Eluting Coronary Stents Angiographic Analysis of the CILON-T (Influence of CILostazol-Based Triple Antiplatelet Therapy ON Ischemi Complication after Drug-Eluting StenT Implantation) Trial.

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제1저자 서정원 · 교신저자 김효수

PMID 29118299 DOI 10.1536/ihj.16-332 IF 1.4 순환기내과
소속 (5)
  1. Cardiovascular Center, Seoul National University Hospital.
  2. Cardiovascular Center, Seoul National University Bundang Hospital.
  3. Cardiovascular Center, Korea University Guro Hospital.
  4. Heart Center, Konyang University Hospital.
  5. Department of Internal Medicine, College of Medicine, Chungbuk National University.

Abstract

It is not clear if anti-restonotic effect of cilostazol is consistent for different types of drug-eluting stents (DES).The purpose of this study was to compare the anti-proliferative effect of cilostazol between DAT and TAT with consideration of confounding influences of DES type.Nine hundred and fifteen patients were randomized to either dual antiplatelet therapy (DAT; aspirin and clopidogrel) or triple antiplatelet therapy (TAT; aspirin, clopidogrel, and cilostazol) in the previous CILON-T trial. After excluding 70 patients who received both or neither stents, we analyzed 845 patients who received exclusively PES or ZES, and compared in-stent late loss at 6 months between both antiplatelet regimens (DAT versus TAT).Baseline angiographic and clinical characteristics were similar between the DAT (656 lesions in 425 patients) and the TAT group (600 lesions in 420 patients). The 6-month follow-up angiography was completed in 745 patients (88.2%). Quantitative coronary angiography showed that TAT significantly reduced in-stent late loss (DAT 0.62 ± 0.62 mm versus TAT 0.54 ± 0.49 mm, P = 0.015). Stent type, diabetes or lesion length did not interact with difference of late loss. However, reduction of late loss by cilostazol did not lead to a significant reduction in the rate of target lesion revascularization (TLR) (DAT 7.8% versus TAT 6.9%, P = 0.69) due to a nonlinear relationship found between late loss and TLR.The TAT group showed less in-stent late loss as compared to the DAT group. This was consistently observed regardless of DES type, lesion length, or diabetic status. However, reduction of late loss by cilostazol did not lead to a significant reduction in TLR.

Keywords

CilostazolPaclitaxel-eluting stentRestenosisZotarolimus-eluting stent

그 밖의 정보
출판 형태
Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial
저널
International heart journal · eISSN 1349-3299
전자 출판
2017-11-08
MeSH
Aged · Antineoplastic Agents / therapeutic use · Cilostazol · Coronary Angiography · Coronary Restenosis / diagnostic imaging / prevention & control · Drug Therapy, Combination · Drug-Eluting Stents* · Female · Humans · Male · Middle Aged · Paclitaxel / therapeutic use · Percutaneous Coronary Intervention · Platelet Aggregation Inhibitors / therapeutic use · Prospective Studies · Sirolimus / analogs & derivatives / therapeutic use · Tetrazoles / therapeutic use
Substances
Antineoplastic Agents · Platelet Aggregation Inhibitors · Tetrazoles · zotarolimus · Cilostazol · Paclitaxel · Sirolimus