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2004 ; 19
(4
): 230-6
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Effects of cilostazol on platelet activation in coronary stenting patients who
already treated with aspirin and clopidogrel
#MMPMID15683111
Ahn JC
; Song WH
; Kwon JA
; Park CG
; Seo HS
; Oh DJ
; Rho YM
Korean J Intern Med
2004[Dec]; 19
(4
): 230-6
PMID15683111
show ga
BACKGROUND: A recent study has shown that triple anti-platelet therapy
(cilostazol+clopidogrel+aspirin) resulted in a significantly lower restenosis
rate after coronary stenting than did conventional therapy (clopidogrel+aspirin).
However, the anti-platelet effects of cilostazol, when combined with clopidogrel
and aspirin, have not been evaluated. METHODS: Low dose cilostazol (50 mg/BID)
was given to 47 patients who had already been taking clopidogrel (75 mg/day) and
aspirin (100 mg/day) for more than 1 month subsequent to coronary stenting due to
AMI and unstable angina. Markers of platelet activation, P-selectin and activated
GPIIb/IIIa on platelets, were measured at baseline and 2 weeks after cilostazol
treatment. We empirically divided patients into tertiles (low, n =16; moderate, n
= 14; high group, n = 17), according to the baseline P-selectin expression. We
then performed a comparative assessment of the anti-platelet effects of
cilostazol at baseline and after 2 weeks of cilosatzol administration. RESULTS:
P-selectin was significantly decreased after 2 weeks of cilostazol treatment in
total patients (n = 47, 3.2 +/- 2.4% to 2.0 +/- 1.9%, p = 0.03). This inhibition
of P-selectin expression was mainly achieved in the moderate and high P-selectin
groups (low group; 1.4 +/- 0.5 to 1.9 +/- 1.3%, p > 0.05, moderate group; 2.5 +/-
0.3 to 1.3 +/- 0.3%, p < 0.05, high group; 5.4 +/- 2.7 to 2.7 +/- 2.8%, p <
0.05). Activated GPIIb/IIIa was not significantly changed (13.5% to 17.6%, p >
0.05). Underying disease, cardiovascular risk factors, concomitant medication
including statin, and hsCRP were not related to the degree of P-selectin
expression. CONCLUSION: Our data demonstrated that cilostazol treatment in
addition to conventional anti-platelet therapy provides more effective
suppression of platelet P-selectin expression in patients with relatively high
platelet activity.
|Aspirin/*therapeutic use
[MESH]
|Cilostazol
[MESH]
|Clopidogrel
[MESH]
|Dose-Response Relationship, Drug
[MESH]
|Drug Therapy, Combination
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Myocardial Ischemia/surgery
[MESH]
|P-Selectin/blood
[MESH]
|Platelet Aggregation Inhibitors/*therapeutic use
[MESH]