A Randomized Study Assessing the Effects of Pretreatment with Cilostazol on Periprocedural Myonecrosis after Percutaneous Coronary Intervention.
10.3349/ymj.2011.52.5.717
- Author:
Byeong Keuk KIM
1
;
Seung Jin OH
;
Se Jung YOON
;
Dong Woon JEON
;
Young Guk KO
;
Joo Young YANG
Author Information
1. Cardiology Division, Cardiovascular Center of National Health Insurance Corporation Ilsan Hospital, Goyang, Korea. kbk2565@freechal.com
- Publication Type:Original Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Coronary disease;
myocardial infarction;
stents
- MeSH:
Aged;
Angina, Stable/drug therapy/enzymology/therapy;
Angioplasty, Balloon, Coronary/*adverse effects;
Creatine Kinase, MB Form/blood;
Female;
Heart Injuries/etiology/prevention & control;
Humans;
Male;
Middle Aged;
Myocardium/pathology;
Necrosis;
Phosphodiesterase 3 Inhibitors/*administration & dosage;
Prospective Studies;
Tetrazoles/*administration & dosage
- From:Yonsei Medical Journal
2011;52(5):717-726
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: It is unknown whether cilostazol pretreatment reduces postprocedural myonecrosis (PPMN). Cilostazol pretreatment reduces PPMN after percutaneous coronary intervention (PCI). MATERIALS AND METHODS: A total of 120 patients with stable angina scheduled for elective PCI were randomly assigned to a 7-day pretreatment with Cilostazol (200 mg/day) or to a control group. Creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) levels were measured at baseline and at 6 and 24 hours after PCI. The primary end-point was the occurrence of PPMN, defined as any CK-MB elevation above the upper normal limit (UNL). Aspirin and clopidogrel were co-administered for 7 days before PCI, and resistance to these agents was then assayed using the VerifyNow System. RESULTS: There was no difference in baseline characteristics between the final analyzable cilostazol (n=54) and the control group (n=56). Despite a significantly greater % inhibition of clopidogrel in the cilostazol group (39+/-23% versus 25+/-22%, p=0.003), the incidence of PPMN was similar between the cilostazol group (24%) and the control group (25%, p=1.000). The rate of CK-MB elevation at > or =3 times UNL was also similar between the two groups (6% versus 5%, p=0.583). The incidence of cTnI increase over the UNL or to 3 times the UNL was not different between the two groups. There was no significant difference in terms of the rate of adverse events during follow-up, although the cilostazol group showed a tendency to have a slightly higher incidence of entry site hematoma. CONCLUSION: This trial demonstrated that adjunctive cilostazol pretreatment might not significantly reduce PPMN after elective PCI in patients with stable angina.
