The Effectiveness and Safety of Triple-Antiplatelet Treatment Based on Cilostazol for Patients Receiving Percutaneous Coronary Intervention: A Meta-Analysis
Article first published online: 14 MAY 2012
© 2012 Wiley Periodicals, Inc.
Volume 35, Issue 10, pages 598–604, October 2012
How to Cite
Wang, P., Zhou, S., Zhou, R., Liu, G., Tang, P., He, J., Ma, C., He, Y. and Yang, J. (2012), The Effectiveness and Safety of Triple-Antiplatelet Treatment Based on Cilostazol for Patients Receiving Percutaneous Coronary Intervention: A Meta-Analysis. Clin Cardiol, 35: 598–604. doi: 10.1002/clc.22001
- Issue published online: 4 OCT 2012
- Article first published online: 14 MAY 2012
- Manuscript Revised: 28 MAR 2012
- Manuscript Received: 31 JAN 2012
The combination of cilostazol, aspirin, and clopidogrel (triple therapy) after percutaneous coronary intervention has been considered as an alternative therapy. We performed a meta-analysis based on 8 randomized controlled trials with a total of 3332 patients to compare the effectiveness and safety of this triple therapy with traditional dual therapy (aspirin and clopidogrel). Our findings suggested that the triple therapy is more effective than dual therapy in preventing restenosis (odds ratio [OR]: 0.52, 95% confidence interval [CI]: 0.40–0.66, P < 0.00001), maintaining minimal lumen diameter (OR: 0.15, 95% CI: 0.10–0.20, P < 0.00001), and avoiding target-vessel revascularization (OR: 0.62, 95% CI: 0.47–0.82, P = 0.001). There is also no significant difference in major adverse cardiac and cerebrovascular events between the 2 therapies, except the smaller occurrence rate of target-lesion revascularization in the triple-therapy group (OR: 0.42, 95% CI: 0.26–0.69, P = 0.0005). However, the triple therapy is associated with a higher level of adverse drug events, including rash (OR: 2.45, 95% CI: 1.41–4.23, P = 0.001), gastrointestinal disorders (OR: 2.59, 95% CI: 1.26–5.30, P = 0.009), and drug discontinuation (OR: 3.80, 95% CI: 1.59–9.10, P = 0.003), but it has no difference in bleeding compared with the dual therapy (OR: 1.05, 95% CI: 0.71–1.55, P = 0.80).
Additional Supporting Information may be found in the online version of this article.
Ping Wang, MS and Shijie Zhou, MS contributed equally to this article. The authors have no funding, financial relationships, or conflicts of interest to disclose.