American Heart Journal
Volume 148, Issue 6 , Pages 990-997 , December 2004

Cilostazol, clopidogrel or ticlopidine to prevent sub-acute stent thrombosis: A meta-analysis of randomized trials

  • Mark D. Schleinitz, MD, MS

      Affiliations

    • Division of General Internal Medicine, Brown University and Rhode Island Hospital, Providence, RI, USA
    • Corresponding Author InformationReprint requests: Mark D. Schleinitz, MD, MS, Rhode Island Hospital, Division of GIM, 593 Eddy St, MPB-1, Providence, RI 02903, USA.
    • ,
  • Ingram Olkin, PhD

      Affiliations

    • Department of Statistics, Stanford University, Stanford, Calif, USA
    • ,
  • Paul A. Heidenreich, MD, MS

      Affiliations

    • Division of Cardiology, Stanford University Medical Center and VA Palo Alto Healthcare System, Stanford and Palo Alto, Calif, USA

References 

  1. Sigwart U, Puel J, Mirkovitch V, et al.  Intravascular stents to prevent occlusion and restenosis after transluminal angioplasty. N Engl J Med. 1987;316:701–706
  2. Schuhlen H, Kastrati A, Dirschinger J, et al.  Intracoronary stenting and risk for major adverse cardiac events during the first month. Circulation. 1998;98:104–111
  3. Orford JL, Lennon R, Melby S, et al.  Frequency and correlates of coronary stent thrombosis in the modern era: analysis of a single center registry. J Am Coll Cardiol. 2002;40:1567–1572
  4. Serruys PW, Strauss BH, Beatt KJ, et al.  Angiographic follow-up after placement of a self-expanding coronary-artery stent. N Engl J Med. 1991;324:13–17
  5. Mak KH, Belli G, Ellis SG, et al.  Subacute stent thrombosis: evolving issues and current concepts. J Am Coll Cardiol. 1996;27:494–503
  6. Serruys PW, de Jaegere P, Kiemeneij F, et al.  A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. N Engl J Med. 1994;331:489–495
  7. Fischman DL, Leon MB, Baim DS, et al.  A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. Stent Restenosis Study Investigators. N Engl J Med. 1994;331:496–501
  8. Leon MB, Baim DS, Popma JJ, et al.  A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. Stent Anticoagulation Restenosis Study Investigators. N Engl J Med. 1998;339:1665–1671
  9. Schomig A, Neumann FJ, Kastrati A, et al.  A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med. 1996;334:1084–1089
  10. Urban P, Macaya C, Rupprecht HJ, et al.  Randomized evaluation of anticoagulation versus antiplatelet therapy after coronary stent implantation in high-risk patients: the multicenter aspirin and ticlopidine trial after intracoronary stenting (MATTIS). Circulation. 1998;98:2126–2132
  11. Bertrand ME, Legrand V, Boland J, et al.  Randomized multicenter comparison of conventional anticoagulation versus antiplatelet therapy in unplanned and elective coronary stenting. The full anticoagulation versus aspirin and ticlopidine (FANTASTIC) study. Circulation. 1998;98:1597–1603
  12. Foussas S, Alexopoulos D, Stefanadis C, et al.  Antiplatelet is superior to anticoagulant treatment after coronary stenting: fewer coronary and other events within 30 days after stenting. Angiology. 2000;51:289–294
  13. Gent M, Blakely JA, Easton JD, et al.  The Canadian American Ticlopidine Study (CATS) in thromboembolic stroke. Lancet. 1989;1:1215–1220
  14. Bennett CL, Weinberg PD, Rozenberg-Ben-Dror K, et al.  Thrombotic thrombocytopenic purpura associated with ticlopidine (A review of 60 cases). Ann Intern Med. 1998;128:541–544
  15. Iqbal M, Goenka P, Young MF, et al.  Ticlopidine-induced cholestatic hepatitis: report of three cases and review of the literature. Dig Dis Sci. 1998;43:2223–2226
  16. Muller C, Buttner HJ, Petersen J, et al.  A randomized comparison of clopidogrel and aspirin versus ticlopidine and aspirin after the placement of coronary-artery stents. Circulation. 2000;101:590–593
  17. Bertrand ME, Rupprecht HJ, Urban P, et al.  Double-blind study of the safety of clopidogrel with and without a loading dose in combination with aspirin compared with ticlopidine in combination with aspirin after coronary stenting: the clopidogrel aspirin stent international cooperative study (CLASSICS). Circulation. 2000;102:624–629
  18. Taniuchi M, Kurz HI, Lasala JM. Randomized comparison of ticlopidine and clopidogrel after intracoronary stent implantation in a broad patient population. Circulation. 2001;104:539–543
  19. Piamsomboon C, Laothavorn P, Chatlaong B, et al.  Effectiveness of clopidogrel and aspirin versus ticlopidine and aspirin after coronary stent implantation: 1 and 6-month follow-up. J Med Assoc Thai. 2001;84:1701–1707
  20. Kunishima T, Musha H, Eto F, et al.  A randomized trial of aspirin versus cilostazol therapy after successful coronary stent implantation. Clin Ther. 1997;19:1058–1066
  21. Park SW, Lee CW, Kim HS, et al.  Comparison of cilostazol versus ticlopidine therapy after stent implantation. Am J Cardiol. 1999;84:511–514
  22. Yoon Y, Shim WH, Lee DH, et al.  Usefulness of cilostazol versus ticlopidine in coronary artery stenting. Am J Cardiol. 1999;84:1375–1380
  23. Ochiai M, Eto K, Takeshita S, et al.  Impact of cilostazol on clinical and angiographic outcome after primary stenting for acute myocardial infarction. Am J Cardiol. 1999;84:1074–1076
  24. Sekiya M, Funada J, Watanabe K, et al.  Effects of probucol and cilostazol alone and in combination on frequency of poststenting restenosis. Am J Cardiol. 1998;82:144–147
  25. Kozuma K, Hara K, Yamasaki M, et al.  Effects of cilostazol on late lumen loss and repeat revascularization after Palmaz-Schatz coronary stent implantation. Am Heart J. 2001;141:124–130
  26. Kamishirado H, Inoue T, Mizoguchi K, et al.  Randomized comparison of cilostazol versus ticlopidine hydrochloride for antiplatelet therapy after coronary stent implantation for prevention of late restensosis. Am Heart J. 2002;144:303–308
  27. Gleser LJ, Olkin I. Meta-analysis for 2×2 tables with multiple treatment groups. In:  Stangl D,  Berry D editor. Meta-analysis in medicine and health policy. New York, NY: Marcel Dekker; 2000.; p. 179–89
  28. Hall P, Nakamura S, Maiello L, et al.  A randomized comparison of combined ticlopidine and aspirin therapy versus aspirin therapy alone after successful intravascular ultrasound-guided stent implantation. Circulation. 1996;93:215–222
  29. Mishkel GJ, Aguirre FV, Ligon RW, et al.  Clopidogrel as adjunctive antiplatelet therapy during coronary stenting. J Am Coll Cardiol. 1999;34:1884–1890
  30. Dangas G, Mehran R, Abizaid AS, et al.  Combination therapy with aspirin plus clopidogrel versus aspirin plus ticlopidine for prevention of subacute thrombosis after successful native coronary stenting. Am J Cardiol. 2001;87:470–472
  31. Calver AL, Blows LJ, Harmer S, et al.  Clopidogrel for prevention of major cardiac events after coronary stent implantation: 30-day and 6-month results in patients with smaller stents. Am Heart J. 2000;140:483–491
  32. Berger PB, Bell MR, Rihal CS, et al.  Clopidogrel versus ticlopidine after intracoronary stent placement. J Am Coll Cardiol. 1999;34:1891–1894
  33. Moussa I, Oetgen M, Roubin G, et al.  Effectiveness of clopidogrel and aspirin versus ticlopidine and aspirin in preventing stent thrombosis after coronary stent implantation. Circulation. 1999;99:2364–2366
  34. Pache J, Kastrati A, Mehilli J, et al.  Clopidogrel therapy in patients undergoing coronary stenting: value of a high-loading-dose regimen. Catheter Cardiovasc Interv. 2002;55:436–441
  35. Tanabe Y, Ito E, Nakagawa I, et al.  Effect of cilostazol on restenosis after coronary angioplasty and stenting in comparison to conventional coronary artery stenting with ticlopidine. Int J Cardiol. 2001;78:285–291
  36. L'Allier PL, Aronow HD, Cura FA, et al.  Clopidogrel is associated with better in-hospital and 30-day outcomes than ticlopidine after coronary stenting. Can J Cardiol. 2003;19:1041–1046
  37. Bhatt D, Bertrand M, Berger P, et al.  Meta-analysis of randomized and registry comparisons of ticlopidine with clopidogrel after stenting. J Am Coll Cardiol. 2002;39:9–14
  38. Dawson DL, Cutler BS, Meissner MH, et al.  Cilostazol has beneficial effects in treatment of intermittent claudication: results from a multicenter, randomized, prospective, double-blind trial. Circulation. 1998;98:678–686
  39. Ikeda Y, Kikuchi M, Murakami H, et al.  Comparison of the inhibitory effects of cilostazol, acetylsalicylic acid and ticlopidine on platelet functions ex vivo (Randomized, double-blind cross-over study). Arzneimittelforschung. 1987;37:563–566
  40. Park SJ, Shim WH, Ho DS, et al.  A paclitaxel-eluting stent for the prevention of coronary restenosis. N Engl J Med. 2003;348:1537–1545
  41. Berger PB, Bell MR, Hasdai D, et al.  Safety and efficacy of ticlopidine for only 2 weeks after successful intracoronary stent placement. Circulation. 1999;99:248–253
  42. Schuhlen H, Kastrati A, Pache J, et al.  Incidence of thrombotic occlusion and major adverse cardiac events between two and four weeks after coronary stent placement: analysis of 5,678 patients with a four-week ticlopidine regimen. J Am Coll Cardiol. 2001;37:2066–2073
  43. Steinhubl SR, Berger PB, Mann JT, et al.  Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA. 2002;288:2411–2420
  44. Park S, Lee CW, Kim H, et al.  Effects of cilostazol on angiographic restenosis after coronary stent placement. Am J Cardiol. 2000;86:499–503
  45. Bennett CL, Connors JM, Carwile JM, et al.  Thrombotic thrombocytopenic purpura associated with clopidogrel. N Engl J Med. 2000;342:1773–1777
  46. Bennett CL, Connors JM, Moake JL. N Engl J Med. 2000;343:1193–1194
  47. Packer M, Carver JR, Rodeheffer RJ, et al.  Effect of oral milrinone on mortality in severe chronic heart failure. The PROMISE study research group. N Engl J Med. 1991;325:1468–1475
  48. Cone J, Wang S, Tandon N, et al.  Comparison of the effects of cilostazol and milrinone on intracellular cAMP levels and cellular function in platelets and cardiac cells. J Cardiovasc Pharmacol. 1999;34:497–504
  49. Gamssari F, Mahmood H, Ho JS, et al.  Rapid ventricular tachycardias associated with cilostazol use. Tex Heart Inst J. 2002;29:140–142
  50. Pratt CM. Analysis of the cilostazol safety database. Am J Cardiol. 2001;87:28D–33D
  51. Drug Topics Red Book. Montvale, NJ: Thomson PDR; 2003;

☆ Mark Schleinitz was supported in part by a training grant from the Agency for Healthcare Research and Quality, and BIRCWH grant HD43447-01.

PII: S0002-8703(04)00510-1

doi: 10.1016/j.ahj.2004.03.066

American Heart Journal
Volume 148, Issue 6 , Pages 990-997 , December 2004

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