PMID- 24152567
OWN - NLM
STAT- MEDLINE
DCOM- 20140701
LR  - 20181202
IS  - 1473-5830 (Electronic)
IS  - 0954-6928 (Linking)
VI  - 24
IP  - 8
DP  - 2013 Dec
TI  - Effect of cilostazol addition or clopidogrel doubling on platelet function 
      profiles in diabetic patients undergoing a percutaneous coronary intervention.
PG  - 690-7
LID - 10.1097/MCA.0000000000000026 [doi]
AB  - BACKGROUND: We investigated the pharmacodynamic effect of cilostazol addition 
      (100 mg twice, Triple) or clopidogrel doubling (150 mg daily, Double) on standard 
      dual antiplatelet therapy in type 2 diabetes mellitus (T2DM) patients with 
      clopidogrel resistance undergoing a percutaneous coronary intervention. METHODS 
      AND RESULTS: This was a prospective, randomized, cross-over platelet function 
      study. Percent inhibition less than 20% was used as the cutoff value of 
      clopidogrel resistance. After percutaneous coronary intervention, a total of 50 
      T2DM patients with clopidogrel resistance were assigned to receive cilostazol 100 
      mg twice daily or clopidogrel 150 mg daily for 28 days; afterwards, they received 
      cross-over treatment for another 28 days. Eight patients were excluded because of 
      side effects and follow-up loss. The platelet function test using VerifyNow was 
      performed at three time points: at baseline (T0), 28 days after randomization 
      (T1), and 28 days after cross-over treatment (T2).A total of 42 T2DM patients 
      completed the study protocol. The clopidogrel resistance improved significantly 
      following cilostazol addition or clopidogrel doubling treatment compared with 
      baseline (52.9+/-27.0 in Triple, 45.4+/-16.8% in Double, P<0.001 in both). This 
      effect continued after cross-over treatment (58.1+/-26.1 and 41.0+/-20.0%, 
      respectively, both P<0.05). A head-to-head comparison between two groups showed a 
      lower P2Y12 reaction unit (PRU) and higher percentage of platelet inhibition in 
      the Triple than those in the Double group (PRU, 138.7+/-88.2 vs. 198.8+/-19.5, 
      P=0.049; %platelet inhibition, 58.1+/-26.1 vs. 40.97+/-20.0, P=0.048). CONCLUSION: 
      Adjunctive treatment with cilostazol in T2DM patients on standard dual 
      antiplatelet therapy might be a more effective strategy for overcoming 
      clopidogrel resistance than clopidogrel doubling treatment.
FAU - Ha, Sang Jin
AU  - Ha SJ
AD  - aDepartment of Internal Medicine, School of Medicine, Division of Cardiology, 
      Kyung Hee University bCardiovascular Center, Kyung Sang University, Seoul, Korea.
FAU - Kim, Soo-Joong
AU  - Kim SJ
FAU - Hwang, Seok-Jae
AU  - Hwang SJ
FAU - Woo, Jong Shin
AU  - Woo JS
FAU - Kim, Weon
AU  - Kim W
FAU - Kim, Woo-Shik
AU  - Kim WS
FAU - Kim, Kwon Sam
AU  - Kim KS
FAU - Kim, Myeong Kon
AU  - Kim MK
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Coron Artery Dis
JT  - Coronary artery disease
JID - 9011445
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Tetrazoles)
RN  - A74586SNO7 (Clopidogrel)
RN  - N7Z035406B (Cilostazol)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
MH  - Blood Platelets/*drug effects
MH  - Cilostazol
MH  - Clopidogrel
MH  - Coronary Angiography
MH  - Coronary Artery Disease/blood/complications/diagnosis/*therapy
MH  - Cross-Over Studies
MH  - Diabetes Mellitus, Type 2/blood/*complications/diagnosis
MH  - Drug Resistance
MH  - Drug Therapy, Combination
MH  - Humans
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects
MH  - Platelet Function Tests
MH  - Prospective Studies
MH  - Republic of Korea
MH  - Tetrazoles/*administration & dosage/adverse effects
MH  - Ticlopidine/administration & dosage/adverse effects/*analogs & derivatives
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2013/10/25 06:00
MHDA- 2014/07/02 06:00
CRDT- 2013/10/25 06:00
PHST- 2013/10/25 06:00 [entrez]
PHST- 2013/10/25 06:00 [pubmed]
PHST- 2014/07/02 06:00 [medline]
AID - 10.1097/MCA.0000000000000026 [doi]
PST - ppublish
SO  - Coron Artery Dis. 2013 Dec;24(8):690-7. doi: 10.1097/MCA.0000000000000026.