In a nutshell
This paper studied the outcome of adding cilostazol (Pletal) to aspirin in patients undergoing percutaneous coronary intervention. The authors found that this reduced rates of heart attack, stroke or revascularization.
Some background
Percutaneous coronary intervention is a procedure done to improve blood flow in blocked blood vessels. Aspirin is a drug that is used to prevent heart attacks and strokes. It is commonly given after a percutnaous coronary intervention procedure. Cilostazol is a drug that prevents platelets (a type of red blood cell) from sticking together and improves blood flow. It has been shown to be effective in preventing stroke. It has been suggested that a combination of aspirin and another drug can improve outcomes in the long term. It is not clear how adding clilostazol to aspirin can improve long-term outcomes.
Methods & findings
514 patients who underwent percutaneous coronary intervention were analyzed. 254 patients received aspirin and cilostazol while 260 patients received aspirin only. 74.7% of patients were men and 39.9% of patients had diabetes. 40.1% of patients had a previous heart attack and 37.4% of patients had a previous stroke. Patients were followed for 2 years.
Patients who received aspirin and cilostazol were 39% less at risk of a heart attack, stroke, or revascularization (surgical procedure done to allow blood flow).
Analysis showed that a previous stroke increased the risk of heart attack, stroke or revascularisation by 2.09 times.
Bleeding rates occurred with similar frequency in patients taking aspirin and cilostazol and patients taking aspirin only.
14.2% of patients receiving aspirin plus cilostazol stopped taking medication for more than 7 days compared to 3.8% of patients taking aspirin only. The main reasons for stopping the drug in patients receiving aspirin and cilostazol were headache and palpitations. The main reason for stopping medication in patients receiving aspirin only was bleeding.
The bottom line
The authors concluded that patients who received cilostazol and aspirin had lower rates of heart attack, stroke and revascularisation than patients who received aspirin alone.
The fine print
The types of percutaneous intervention procedure were different among patients.
What’s next?
Talk to your doctor about long term medication after a percutaneous coronary intervention.
Published By :
American heart journal
Date :
Mar 01, 2016
