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Triple versus dual antiplatelet therapy for coronary heart disease patients undergoing percutaneous coronary

Hong Zhou1, Xiao-Ling Feng, Hong-Ying Zhang

  • 1Department of Emergency, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, P.R. China.

Experimental and Therapeutic Medicine
|October 19, 2013
PubMed

Insights

Cilostazol-based triple antiplatelet therapy (TAT) significantly reduces restenosis, major adverse cardiac events, and target lesion revascularization in patients with coronary heart disease undergoing percutaneous coronary intervention compared to dual antiplatelet therapy (DAT). TAT demonstrates improved efficacy and safety.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Coronary heart disease (CHD) remains a leading global cause of mortality.
  • Percutaneous coronary intervention (PCI) is a common treatment for CHD.
  • Dual antiplatelet therapy (DAT) is standard post-PCI, but triple antiplatelet therapy (TAT) with cilostazol is being investigated.

Purpose of the Study:

  • To compare the clinical outcomes of cilostazol-based TAT versus conventional DAT in patients with CHD undergoing PCI.
  • To evaluate the efficacy and safety of TAT in this patient population through a meta-analysis.

Main Methods:

  • Meta-analysis of ten controlled clinical studies.
  • Inclusion of 7,670 patients with CHD undergoing PCI.
  • Comparison between 3,925 patients on DAT (aspirin and clopidogrel) and 3,745 patients on TAT (DAT plus cilostazol).

Main Results:

  • TAT significantly reduced restenosis (OR=0.59), major adverse cardiac events (MACE, OR=0.69), and target lesion revascularization (TLR, OR=0.61) compared to DAT.
  • No significant differences were found in mortality, myocardial infarction, target vessel revascularization, or stent thrombosis between the groups.
  • Statistical significance was determined using fixed or random effects models with 95% confidence intervals.

Conclusions:

  • Cilostazol-based TAT is more effective than conventional DAT for patients with CHD undergoing PCI.
  • TAT demonstrates a favorable safety profile, with reduced rates of key adverse events.
  • The findings support the consideration of TAT in specific patient groups undergoing PCI.

Keywords:
antiplatelet therapycilostazolcoronary heart diseasemeta-analysispercutaneous coronary intervention

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