Impact of cilostazol on restenosis after percutaneous coronary balloon angioplasty

Background-Restenosis after percutaneous transluminal coronary (balloon) an gioplasty (PTCA) remains a major drawback of the procedure. We previously r eported that cilostazol, a platelet aggregation inhibitor, inhibited intima l proliferation after directional coronary atherectomy and reduced the rest enosis rate in humans. The present study aimed to determine the effect of c ilostazol on restenosis after PTCA, Methods and Results-Two hundred eleven patients with 273 lesions who underw ent successful PTCA were randomly assigned to the cilostazol (200 mg/d) gro up or the aspirin (250 mg/d) control group. Administration of cilostazol wa s initiated immediately after PTCA and continued for 3 months of follow-up. Quantitative coronary angiography was performed before PTCA and after PTCA and at follow-up, Reference diameter, minimal lumen diameter, and percent diameter stenosis (DS) were measured by quantitative coronary angiography. Angiographic restenosis was defined as DS at follow-up >50%. Eligible follo w-up angiography was performed in 94 patients with 123 lesions in the cilos tazol group and in 99 patients with 129 lesions in the control group. The b aseline characteristics and results of PTCA showed no significant differenc e between the 2 groups. However, minimal lumen diameter at follow-up was si gnificantly larger (1.65 +/- 0.55 vs 1.37 +/- 0.58 mm; P < 0.0001) and DS w as significantly lower (34.1 +/- 17.8% vs 45.6 +/- 19.3%; P < 0.0001.) in t he cilostazol group. Restenosis and target lesion revascularization rates w ere also significantly lower in the cilostazol group (17.9% vs 39.5%; P < 0 .001 and 11.4% vs 28.7%; P < 0.001). Conclusions-Cilostazol significantly reduces restenosis and target lesion r evascularization rates after successful PTCA.