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Reduced Platelet Reactivity After Adjunctive Cilostazol

It reduces high post-treatment platelet reactivity better than maintenance clopidogrel

FRIDAY, March 27 (HealthDay News) -- In patients undergoing coronary stenting who develop high post-treatment platelet reactivity (HPPR), adjunctive cilostazol reduces platelet aggregation better than maintenance clopidogrel, researchers report in the March 31 issue of the Journal of the American College of Cardiology.

Young-Hoon Jeong, M.D., Ph.D., from Gyeongsang National University Hospital in Jinju, Korea, and colleagues randomly assigned 60 patients with HPPR who had received aspirin and a 300-mg loading dose of clopidogrel and undergone coronary stenting to either adjunctive cilostazol (100 mg twice a day) or high maintenance dose clopidogrel (150 mg per day). All patients received aspirin daily throughout the study.

At 30 days, the researchers found that significantly fewer patients in the cilostazol group had HPPR (3.3 versus 26.7 percent). This group also had significantly reduced platelet aggregation, as determined by adenosine diphosphate (ADP)-induced late and maximal platelet aggregation, as well as a greater anti-platelet effect as determined by a greater change in ADP-induced platelet aggregation specific to the platelet P2Y12 receptor (39.6 versus 23.1 percent), the authors report.

"Among patients with HPPR undergoing coronary stenting, adjunctive cilostazol reduces the rate of HPPR and achieves intensified platelet inhibition as compared with high maintenance dose clopidogrel of 150 mg/day," Jeong and colleagues conclude. "It needs to be evaluated whether reduction of HPPR with triple antiplatelet therapy could be translated into improved clinical outcomes."

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