ANTIPLATELET TREATMENT WITH CILOSTAZOL AFTER STENT IMPLANTATION

Objectives-To evaluate the efficacy cilostazol, a new synthetic inhibi tor of phosphodiesterase, in preventing stent thrombosis after success ful implantation. Design-Preliminary prospective study. Setting-A sing le coronary care unit in Japan. Patients-Elective, bailout, or primary stents were implanted in 85 consecutive patients with 93 lesions. Pri mary stent implantation was performed in 18 patients with acute myocar dial infarction. Patients received 200 mg cilostazol and 243 mg aspiri n after stenting. Main outcome measures-Stent thrombosis, major and mi nor complications, and side effects were assessed in the six months af ter stenting. Results-Gianturco-Roubin stents were implanted in 37 les ions, Wiktor stents in 55, and Palmaz-Schatz stents in 27. Multiple st ents were used in 26 lesions. There was no mortality, stent thrombosis related Q wave myocardial infarction, emergency bypass surgery, repea t intervention, or vascular complications in the six months of follow up. Acute or subacute closure did not occur after stenting. There were no serious side effects such as leucopenia and/or abnormal liver func tion for three months. Cilostazol was withdrawn in one patient because of skin rash. Patients who underwent primary stenting had no clinical events, such as acute or subacute thrombosis, or side effects. Conclu sions-Cilostazol is an effective antiplatelet agent with minimum side effects after elective, bailout, or primary stent implantation.