Long-term clinical efficacy and safety of adding cilostazol to dual antiplatelet therapy after drug-eluting stent implantation in coronary arteries: A meta-analysis of randomized controlled trials

Thrombosis Research
Yandun ZouAidong Zhang

Abstract

To assess the long-term clinical efficacy and safety of adding cilostazol (TAT) to conventional dual antiplatelet therapy (DAT) for patients undergoing drug-eluting stent (DES) implantation in coronary arteries. We performed PUBMED, MEDLINE, EMBASE, and Cochrane CENTRAL searches for randomized clinical trials of TAT versus DAT in patients after DES implantation with criteria to include trials with a follow-up of more than 6months. Seven RCTs with a total of 3487 patients were included in this review. The meta-analysis showed that TAT was associated with a significant reduction in major adverse cardiac events (MACEs) (relative risk (RR)=0.66; 95% CI=0.50-0.88), target lesion revascularization (TLR) (RR=0.61, 95% CI=0.43-0.84), target vessel revascularization (TVR) (RR=0.53, 95% CI=0.37-0.75), in-stent restenosis (RR=0.64, 95% CI=0.44-0.85), in-segment restenosis (RR=0.58, 95% CI=0.43-0.79, P<.01), in-stent late loss (LL) (standardized mean difference (SMD)=-0.21, 95% CI=0.32-0.17), and in-segment LL (SMD=-0.27, 95% CI=-0.38-0.16). TAT also did not appear to significantly alter any of the other meta-analysis secondary efficacy outcomes and had similar rates of bleeding, but TAT had significantly higher rates of rash, gastrointest...Continue Reading

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