Cardiovascular Intervention and Therapeutics

, Volume 27, Issue 3, pp 161–167

The long-term efficacy of cilostazol in addition to dual antiplatelet therapy after sirolimus-eluting stent implantation for Japanese patients: an analysis of the 3-year follow-up outcomes from the j-Cypher registry

  • Tetsushi Nakao
  • Takeshi Kimura
  • Takeshi Morimoto
  • Yutaka Furukawa
  • Yoshihisa Nakagawa
  • Kazushige Kadota
  • Masakiyo Nobuyoshi
  • Toru Kita
  • Kazuaki Mitsudo
Original Article

DOI: 10.1007/s12928-012-0105-4

Cite this article as:
Nakao, T., Kimura, T., Morimoto, T. et al. Cardiovasc Interv and Ther (2012) 27: 161. doi:10.1007/s12928-012-0105-4

Abstract

Several clinical studies have reported the use of cilostazol in addition to aspirin and thienopyridine (triple antiplatelet therapy, TAPT) after percutaneous coronary intervention (PCI) decreases clinical events. However, the efficacy and safety of TAPT have not been fully evaluated in Japan. The prospectively collected data from 12824 Japanese patients received PCI as part of the j-Cypher Registry were analyzed. We selected 10356 patients who exclusively received implantation of sirolimus-eluting stents (SES), and compared the data from 10128 patients who received dual antiplatelet therapy (aspirin + thienopyridine, DAPT) with 228 patients who received TAPT at the time of discharge. Patients who received TAPT had more comorbidities, such as peripheral vascular disease, renal failure with hemodialysis or insulin dependent diabetes mellitus, and more patients received stenting for the left main trunk. The cardiovascular event rates at 3 years after PCI in the TAPT group were not significantly different from DAPT group, even after adjusted risks for cardiovascular events; all-cause death (7.8 vs. 6.7 %, log-rank p = 0.44, adjusted Hazard Ratio [HR] 0.88: 95 % confidence interval [CI] 0.52–1.38, p = 0.61), myocardial infarction (1.7 vs. 2.4 %, log-rank p = 0.49 and HR 0.71: 95 % CI 0.20–1.57, p = 0.40), target legion revascularization (12.7 vs. 9.9 %, log-rank p = 0.11 and HR 1.05: 95 % CI 0.71–1.50, p = 0.91) and stroke (3.9 vs. 3.2 %, log-rank p = 0.52 and HR 1.09: 95 % CI 0.52–2.00, p = 0.80). In conclusion, TAPT after SES implantation was associated with similar long-term clinical outcomes as DAPT in Japanese real-world clinical practice, although we did not evaluate the bleeding outcome.

Keywords

Percutaneous coronary intervention Cilostazol Triple antiplatelet therapy 

Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2012

Authors and Affiliations

  • Tetsushi Nakao
    • 1
  • Takeshi Kimura
    • 1
  • Takeshi Morimoto
    • 2
  • Yutaka Furukawa
    • 3
  • Yoshihisa Nakagawa
    • 4
  • Kazushige Kadota
    • 5
  • Masakiyo Nobuyoshi
    • 6
  • Toru Kita
    • 1
  • Kazuaki Mitsudo
    • 5
  1. 1.Department of Cardiovascular Medicine, Graduate School of MedicineKyoto UniversityKyotoJapan
  2. 2.Center for Medical Education and Clinical Epidemiology Unit, Graduate School of MedicineKyoto UniversityKyotoJapan
  3. 3.Department of Cardiovascular MedicineKobe City Medical Center General HospitalKobeJapan
  4. 4.Division of CardiologyTenri HospitalTenriJapan
  5. 5.Division of CardiologyKurashiki Central HospitalKurashikiJapan
  6. 6.Division of CardiologyKokura Memorial HospitalKokuraJapan

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