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

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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.

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Authors and Affiliations

  1. Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan

    Qiang Fu, Nobuaki Suzuki, Kaoru Takada, Hirosada Yamamoto, Shuichi Ishikawa, Naoyuki Yokoyama, Ken Kozuma & Takaaki Isshiki

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  1. Qiang Fu
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  2. Nobuaki Suzuki
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  3. Kaoru Takada
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  4. Hirosada Yamamoto
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  5. Shuichi Ishikawa
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  6. Naoyuki Yokoyama
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  7. Ken Kozuma
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  8. Takaaki Isshiki
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Correspondence to Nobuaki Suzuki.

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Fu, Q., Suzuki, N., Takada, K. et al. Effect of cilostazol on optimized standard antiplatelet therapy in a patient with a cytochrome P450 2C19 *2/*2 genotype. Cardiovasc Interv and Ther 26, 79–82 (2011). https://doi.org/10.1007/s12928-010-0036-x

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  • DOI: https://doi.org/10.1007/s12928-010-0036-x

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