Efficacy and safety of cilostazol based triple antiplatelet treatment versus dual antiplatelet treatment in patients undergoing coronary stent implantation: an updated meta-analysis of the randomized controlled trials

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• 作者：Jun Chen ; Haoyu Meng ; Lei Xu ; Jie Liu ; Deyu Kong…
• 关键词：Triple antiplatelet therapy ; Dual antiplatelet therapy ; Cilostazol ; Stent implantation
• 刊名：Journal of Thrombosis and Thrombolysis
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：39
• 期：1
• 页码：23-34
• 全文大小：2,448 KB
• 参考文献：1. Kushner FG, Hand M, Smith SC Jr, King SB 3rd, Anderson JL et al (2009) 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 54:2205-241 CrossRef
  2. Kuchulakanti PK, Chu WW, Torguson R, Ohlmann P, Rha SW et al (2006) Correlates and long-term outcomes of angiographically proven stent thrombosis with sirolimus- and paclitaxel-eluting stents. Circulation 113:1108-113 CrossRef
  3. Daemen J, Wenaweser P, Tsuchida K, Abrecht L, Vaina S et al (2007) Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study. Lancet 369:667-78 CrossRef
  4. Smit JJ, van’t Hof AW, de Boer MJ, Hoorntje JC, Dambrink JH et al (2006) Incidence and predictors of subacute thrombosis in patients undergoing primary angioplasty for an acute myocardial infarction. Thromb Haemost 96:190-95
  5. Iakovou I, Schmidt T, Bonizzoni E, Ge L, Sangiorgi GM et al (2005) Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA 293:2126-130 CrossRef
  6. Mehta SR, Yusuf S, Peters RJ, Bertrand ME, Lewis BS et al (2001) Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 358:527-33 CrossRef
  7. Reaume KT, Regal RE, Dorsch MP (2008) Indications for dual antiplatelet therapy with aspirin and clopidogrel: evidence-based recommendations for use. Ann Pharmacother 42:550-57 CrossRef
  8. Goto S (2005) Cilostazol: potential mechanism of action for antithrombotic effects accompanied by a low rate of bleeding. Atheroscler Suppl 6:3-1 CrossRef
  9. Cone J, Wang S, Tandon N, Fong M, Sun B et al (1999) Comparison of the effects of cilostazol and milrinone on intracellular cAMP levels and cellular function in platelets and cardiac cells. J Cardiovasc Pharmacol 34:497-04 CrossRef
  10. Singh I, Shafiq N, Pandhi P, Reddy S, Pattanaik S et al (2009) Triple antiplatelet therapy vs. dual antiplatelet therapy in patients undergoing percutaneous coronary intervention: an evidence-based approach to answering a clinical query. Br J Clin Pharmacol 68:4-3 CrossRef
  11. Min PK, Jung JH, Ko YG, Choi D, Jang Y et al (2007) Effect of cilostazol on in-stent neointimal hyperplasia after coronary artery stenting: a quantitative coronary angiography and volumetric intravascular ultrasound study. Circ J 71:1685-690 CrossRef
  12. Lee SW, Park SW, Kim YH, Yun SC, Park DW et al (2007) Comparison of triple versus dual antiplatelet therapy after drug-eluting stent implantation (from the DECLARE-Long trial). Am J Cardiol 100:1103-108 CrossRef
  13. Lee SW, Park SW, Kim YH, Yun SC, Park DW et al (2008) Drug-eluting stenting followed by cilostazol treatment reduces late restenosis in patients with diabetes mellitus the DECLARE-DIABETES trial (a randomized comparison of triple antiplatelet therapy with dual antiplatelet therapy after drug-eluting stent implantation in diabetic patients). J Am Coll Cardiol 51:1181-187 CrossRef
  
• 作者单位：Jun Chen (1)
  Haoyu Meng (1)
  Lei Xu (1)
  Jie Liu (1) (5)
  Deyu Kong (1)
  Pengsheng Chen (1)
  Xiaoxuan Gong (1)
  Jianling Bai (2)
  Fengwei Zou (3)
  Zhijian Yang (1)
  Chunjian Li (1)
  John W. Eikelboom (4)
  
  1. Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, 300, Guangzhou Road, Nanjing, 210029, China
  5. Department of Cardiology, The Second People’s Hospital of Changzhou City, Changzhou, China
  2. Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
  3. Department of Chemistry, Northwestern University, Evanston, IL, USA
  4. Department of Medicine, McMaster University, Hamilton, ON, Canada
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  Hematology
  
• 出版者：Springer Netherlands
• ISSN：1573-742X

文摘

The aim of this study was to obtain best estimates of the efficacy and safety of cilostazol-based triple antiplatelet therapy (TAPT: aspirin, clopidogrel and cilostazol) compared with dual antiplatelet therapy (DAPT: aspirin and clopidogrel) in patients undergoing coronary stent implantation. We searched the literature to identify all randomized clinical trials examining efficacy and safety of TAPT versus DAPT in patients undergoing coronary stent implantation. Major efficacy outcomes were death, non-fatal myocardial infarction (MI), ischemic stroke and stent thrombosis (ST) and the safety outcome was bleeding. Data were analyzed using the Review Manager 5.0.0 software. A total of 19 trials involving 7,464 patients were included. TAPT and DAPT were associated with similar rates of death, non-fatal MI, ischemic stroke and ST, but compared with DAPT, TAPT had lower rates of target lesion revascularization (TLR) (RR 0.67, 95?% CI 0.56-.82, P?P?P?P?