Loading Effect of 200 mg Cilostazol on Platelet Inhibition in Patients Undergoing Percutaneous Coronary Intervention

Jin, En Ze; Yu, Long; Li, Xue Qi

doi:10.1536/ihj.53.1

Cited by 7 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are also multiple reports of the use of % inhibition. For this study, clopidogrel resistance was defined as a PRU value >230 (12)(13)(14) and/or % inhibition <20% (15)(16)(17). …”

Section: Definition Of Clopidogrel Resistancementioning

confidence: 99%

Relationship between Smoking and Responsiveness to Clopidogrel in Non-cardiogenic Ischemic Stroke Patients

et al. 2014

View full text Add to dashboard Cite

Objective Clopidogrel is used to prevent the recurrence of non-cardiogenic ischemic stroke, but individual responsiveness to the drug varies. Moreover, it is known that smoking, which is a risk factor for ischemic stroke, affects the drug's pharmacokinetics. The objective of the present study was to investigate a possible relationship between smoking and responsiveness to clopidogrel in non-cardiogenic ischemic stroke patients. Methods The study involved 209 non-cardiogenic ischemic stroke patients who were administered oral clopidogrel at a dosage of 75 mg/day for at least 1 week. Platelet aggregation in response to adenosine diphosphate (20 μM) was measured in each patient using the VerifyNow P2Y12 Assay. Platelet aggregation and the incidence of resistance to clopidogrel were compared between a smokers group (70 patients) and a non-smokers group (139 patients). Clopidogrel resistance was defined as a P2Y12 Reaction Units (PRU) value >230 and/or % inhibition <20%. Results The mean PRU was 128.3±85.5 in the smokers group and 167.7±86.6 in the non-smokers group (p=0.002). The incidence of PRU >230 was 12.9% (9 patients) in the smokers group and 25.9% (36 patients) in the non-smokers group (p=0.033). The mean % inhibition was 48.6±30.7% in the smokers group and 36.9±27.6% in the non-smokers group (p=0.009). The incidence of patients with % inhibition <20% was 24.3% (17 patients) in the smokers group and 34.5% (48 patients) in the non-smokers group (p=0.155). Conclusion The incidence of clopidogrel resistance was lower in the non-cardiogenic ischemic stroke patients who were smokers, thus indicating that these patients' responsiveness to this drug may be enhanced.

show abstract

“…There are also multiple reports of the use of % inhibition. For this study, clopidogrel resistance was defined as a PRU value >230 (12)(13)(14) and/or % inhibition <20% (15)(16)(17). …”

Section: Definition Of Clopidogrel Resistancementioning

confidence: 99%

Relationship between Smoking and Responsiveness to Clopidogrel in Non-cardiogenic Ischemic Stroke Patients

et al. 2014

View full text Add to dashboard Cite

show abstract

“…A recently published study showed that the loading dose of 200 mg cilostazol in addition to aspirin and clopidogrel improved platelet responsiveness to clopidogrel in the pre-and postprocedural phases and reduced the prevalence of high posttreatment platelet reactivity. 20 In the present study, loading dose of cilostazol-based triple-antiplatelet therapy plus bivalirudin strategy in patients undergoing PCI improved myocardial perfusion and prognosis.…”

Section: Discussionmentioning

confidence: 56%

Bivalirudin plus loading dose of cilostazol-based triple-antiplatelet in treatment of non-ST-elevation myocardial infarction following percutaneous coronary intervention

Wang

Zhang

Wang

et al. 2015

TCRM

View full text Add to dashboard Cite

ObjectiveTo study the effect of bivalirudin plus loading dose of cilostazol-based triple-antiplatelet therapy strategy in patients undergoing percutaneous coronary intervention (PCI).MethodsOne hundred and fifty-three patients with non-ST-segment elevation myocardial infarction who underwent PCI were divided into control group and cilostazol group. Patients in control group were given aspirin and clopidogrel and those in cilostazol group were given aspirin, clopidogrel, and cilostazol once 2 hours before PCI and for 30 days after PCI. Bivalirudin was given to all patients before and during the PCI.ResultsAfter PCI, the Thrombolysis In Myocardial Infarction myocardial perfusion grade (TMPG) III in cilostazol group was higher than that in control group (89.19% versus 72.15%, P<0.05). At 30 days, the incidence of major adverse cardiac events was significantly lower in cilostazol group compared with that in control group (6.76% versus 17.72%, P<0.05). However, the rates of cardiac death, nonfatal reinfarction, target vessel revascularization, new congestive heart failure, and subacute stent thrombosis did not significantly differ between the two groups. In addition, the rates of minor or major bleeding or thrombocytopenia did not significantly differ between the two groups.ConclusionBivalirudin plus loading dose of cilostazol-based triple-antiplatelet therapy strategy in PCI increased TMPG III, decreased major adverse cardiac events, and did not increase the incidence of bleeding and thrombocytopenia.

show abstract

“…Both triflusal and cilostazol showed efficacy in prevention of ischemic stroke 15)18). They have also shown efficacy by loading dosage 8)14). These make cilostazol and triflusal suitable for coping with aspirin and/or clopidogrel resistance that appear in patients scheduled for any mode of coil embolization.…”

Section: Discussionmentioning

confidence: 99%

Effect of Premedication Method and Drug Resistance of Antiplatelet Agent on Periprocedural Thromboembolic Events During Coil Embolization of an Unruptured Intracranial Aneurysm

Park

Kim

Huh

2012

J Cerebrovasc Endovasc Neurosurg

View full text Add to dashboard Cite

Objective : A retrospective review of premedication method and drug resistance of aspirin and clopidogrel in association with thromboembolic events during and after coil embolization of an unruptured intracranial aneurysm was conducted.Methods : Our premedication policy for coil embolization of an unruptured intracranial aneurysm has changed from administration of the loading dose before the procedure (i.e. loading group) to repeated administration of the maintenance dose for several days (i.e. preparation group). The loading group (27 patients with 29 aneurysms) and the preparation group (30 patients with 35 aneurysms) were compared for identification of the effect of premedication method on periprocedural thromboembolic events. The results of drug response assays of the preparation group were analyzed with respect to periprocedural thromboembolic events.Results : No statistically significant difference in incidence of thromboembolic events was observed between the loading group and the preparation group. Analysis of the results of the drug response assay showed high prevalence (56.7%, 73.3%) of clopidogrel resistance and relatively low prevalence (6.7%) of aspirin resistance. Patients who had thromboembolic events tended to have lower responsiveness to both aspirin and clopidogrel than patients without it.Conclusion : The method of antiplatelet premedication does not affect the rate of periprocedural thromboembolic events in coil embolization for treatment of an unruptured intracranial aneurysm. Nevertheless, considering the high prevalence of drug resistance, it is reasonable to premedicate antiplatelet agents in the preparation method for the drug response assay. Use of a higher dose of aspirin and clopidogrel or addition of an alternative drug (cilostazol or triflusal) can be applied against antiplatelet agent resistance. However, because the hemorrhagic risk associated with this supplementary use of antiplatelet agent has not been well-documented, the hemorrhagic risk and the preventive benefit must be weighed.

show abstract

Loading Effect of 200 mg Cilostazol on Platelet Inhibition in Patients Undergoing Percutaneous Coronary Intervention

Cited by 7 publications

References 18 publications

Relationship between Smoking and Responsiveness to Clopidogrel in Non-cardiogenic Ischemic Stroke Patients

Relationship between Smoking and Responsiveness to Clopidogrel in Non-cardiogenic Ischemic Stroke Patients

Bivalirudin plus loading dose of cilostazol-based triple-antiplatelet in treatment of non-ST-elevation myocardial infarction following percutaneous coronary intervention

Effect of Premedication Method and Drug Resistance of Antiplatelet Agent on Periprocedural Thromboembolic Events During Coil Embolization of an Unruptured Intracranial Aneurysm

Contact Info

Product

Resources

About