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

  • Qiang Fu
  • Nobuaki Suzuki
  • Kaoru Takada
  • Hirosada Yamamoto
  • Shuichi Ishikawa
  • Naoyuki Yokoyama
  • Ken Kozuma
  • Takaaki Isshiki
Case Report

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)

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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2010

Authors and Affiliations

  • Qiang Fu
    • 1
  • Nobuaki Suzuki
    • 1
  • Kaoru Takada
    • 1
  • Hirosada Yamamoto
    • 1
  • Shuichi Ishikawa
    • 1
  • Naoyuki Yokoyama
    • 1
  • Ken Kozuma
    • 1
  • Takaaki Isshiki
    • 1
  1. 1.Department of MedicineTeikyo University School of MedicineTokyoJapan

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