Cardiovascular Intervention and Therapeutics

, Volume 26, Issue 1, pp 79–82

Effect of cilostazol on optimized standard antiplatelet therapy in a patient with a cytochrome P450 2C19 *2/*2 genotype

Authors

  • Qiang Fu
    • Department of MedicineTeikyo University School of Medicine
    • Department of MedicineTeikyo University School of Medicine
  • Kaoru Takada
    • Department of MedicineTeikyo University School of Medicine
  • Hirosada Yamamoto
    • Department of MedicineTeikyo University School of Medicine
  • Shuichi Ishikawa
    • Department of MedicineTeikyo University School of Medicine
  • Naoyuki Yokoyama
    • Department of MedicineTeikyo University School of Medicine
  • Ken Kozuma
    • Department of MedicineTeikyo University School of Medicine
  • Takaaki Isshiki
    • Department of MedicineTeikyo University School of Medicine
Case Report

DOI: 10.1007/s12928-010-0036-x

Cite this article as:
Fu, Q., Suzuki, N., Takada, K. et al. Cardiovasc Interv and Ther (2011) 26: 79. doi:10.1007/s12928-010-0036-x

Abstract

A 54-year-old man with acute coronary syndrome underwent primary percutaneous coronary intervention (PCI) to implant a bare metal stent. Three weeks later, a subclinical in-stent thrombus was found at staged PCI despite dual antiplatelet therapy with aspirin and clopidogrel. Platelet function tests revealed high post-treatment platelet reactivity, indicating an inadequate response to clopidogrel. The patient’s cytochrome P450 2C19 genotype was *2/*2. Cilostazol at 200 mg/day was initiated in addition. Three months later, platelet inhibition was enhanced, and no thrombus was detectable by coronary angiography. Our experience suggests that triple antiplatelet therapy with cilostazol as well as aspirin and clopidogrel could prevent stent thrombosis with improved clopidogrel responsiveness.

Keywords

Acute coronary syndrome Coronary intervention Antiplatelet therapy Stent thrombosis

Supplementary material

12928_2010_36_MOESM1_ESM.avi (55.7 mb)
Supplementary material 1 (AVI 57,064 kb)

Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2010