Effects of cilostazol on angiographic restenosis after coronary stent placement

This study evaluates the impact of cilostazol on poststenting restenosis. C ilostazol is a potent antiplatelet agent with antiproliferative properties. Few data are available about the effect of cilostazol on poststenting rest enosis. Four hundred nine patients (494 lesions) who were scheduled for ele ctive stenting were randomized to receive aspirin plus ticlopidine (group I , n = 201, 240 lesions) or aspirin plus cilostazol (group II, n = 208, 254 lesions), starting 2 days before stenting. Ticlopidine was given for 1 mont h and cilostazol for 6 months. Follow-up angiography was performed at 6 mon ths, and clinical evaluation at regular intervals. Baseline characteristics were similar between the 2 groups. The procedural success rate was 99.6% i n group I and 100% in group II. There were no cases of stent thrombosis aft er stenting. Angiographic follow-up was performed in 380 of the 494 eligibl e lesions and the angiographic restenosis rate was 27% in group I and 22.9% in group II (p = NS). However, diffuse type in-stent restenosis was more c ommon in group I than in group II (54.2% vs 26.8%, respectively, p <0.05). In diabetic patients, the angiographic restenosis rate was 50% in group I a nd 21.7% in group II (p <0.05). Clinical events during follow-up did not di ffer between the 2 groups. In conclusion, aspirin plus cilostazol seems to be an effective antithrombotic regimen with comparable results to aspirin p lus ticlopidine, but it does not reduce the overall angiographic restenosis rate after elective coronary stenting. (C) 2000 by Excerpta Medica, Inc.