Cilostazol eliminates adverse smoking outcome in patients with drug-eluting stent implantation - Analysis of longer-term follow-up of the CILON-T randomized trial -

Hack Lyoung Kim, Jung Won Suh, Seung Pyo Lee, Hyun Jae Kang, Bon Kwon Koo, Young Seok Cho, Tae Jin Youn, In Ho Chae, Dong Ju Choi, Seung-Woon Rha, Jang Ho Bae, Taek Geun Kwon, Jang Whan Bae, Myeong Chan Cho, Hyo Soo Kim

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Abstract

Background: The present study investigated whether cilostazol can eliminate adverse smoking outcome after percutaneous coronary intervention (PCI). Methods and Results: A total of 914 patients with successful drug-eluting stent (DES) implantation were randomly assigned to dual antiplatelet therapy (DAT; aspirin and clopidogrel, n=457) or to triple antiplatelet therapy (TAT; DAT with cilostazol, n=457). The effect of smoking on 2-year major adverse cardio/cerebrovascular events (MACCE) in both the TAT and DAT groups was evaluated. Total MACCE were not significantly different between the 2 anti-platelet regimens (9.8% in TAT vs. 11.4% in DAT groups, P=0.45), but the adverse effects of smoking on clinical outcome were different between DAT vs. TAT. Current smokers had a higher prevalence of MACCE than non-smokers in the DAT group (16.7% vs. 9.5%, P=0.04). In the TAT group, however, the adverse effect of smoking was abolished (9.2% vs. 10.1%, P=0.85). Regarding the effects of smoking on the antiplatelet effects of DAT or TAT, post-treatment platelet reactivity (in P2Y12 reaction units; PRU) in current smokers was not significantly lower than that in non-smokers in the DAT group, whereas, in the TAT group, it was significantly lower than that of non-smokers (189±88 vs. 216±89 PRU, P=0.01). Conclusions: Adverse clinical effects of smoking may be eliminated by the addition of cilostazol to DAT after DES implantation. This may be due to the stimulation of cilostazol's antiplatelet effects by smoking.

Original languageEnglish
Pages (from-to)1420-1427
Number of pages8
JournalCirculation Journal
Volume78
Issue number6
DOIs
Publication statusPublished - 2014 Jan 1

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, H. L., Suh, J. W., Lee, S. P., Kang, H. J., Koo, B. K., Cho, Y. S., Youn, T. J., Chae, I. H., Choi, D. J., Rha, S-W., Bae, J. H., Kwon, T. G., Bae, J. W., Cho, M. C., & Kim, H. S. (2014). Cilostazol eliminates adverse smoking outcome in patients with drug-eluting stent implantation - Analysis of longer-term follow-up of the CILON-T randomized trial -. Circulation Journal, 78(6), 1420-1427. https://doi.org/10.1253/circj.CJ-13-1394