Effects of cilostazol on platelet activation in coronary stenting patients who already treated with aspirin and clopidogrel

Jeong Cheon Ahn, Woohyuk Song, Jung Ah Kwon, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Young Moo Rho

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Abstract

Background: A recent study has shown that triple anti-platelet therapy (cilostazol+clopidogrel+aspirin) resulted in a significantly lower restenosis rate after coronary stenting than did conventional therapy (clopidogrel+aspirin) . However, the anti-platelet effects of cilostazol, when combined with clopidogrel and aspirin, have not been evaluated. Methods: Low dose cilostazol (50 mg/BID) was given to 47 patients who had already been taking clopidogrel (75 mg/day) and aspirin (100 mg/day) for more than 1 month subsequent to coronary stenting due to AMI and unstable angina. Markers of platelet activation, P-selectin and activated GPIIb/IIIa on platelets, were measured at baseline and 2 weeks after cilostazol treatment. We empirically divided patients into tertiles (low, n=16; moderate, n=14; high group, n=17), according to the baseline P-selectin expression. We then performed a comparative assessment of the anti-platelet effects of cilostazol at baseline and after 2 weeks of cilosatzol administration. Results: P-selectin was significantly decreased after 2 weeks of cilostazol treatment in total patients (n=47, 3.2± 2.4% to 2.0±1.9%, p=0.03). This inhibition of P-selectin expression was mainly achieved in the moderate and high P-selectin groups (low group; 1.4±0.5 to 1.9±1.3%, p>0.05, moderate group; 2.5±0.3 to 1.3±0.3%, p<0.05, high group; 5.4±2.7 to 2.7±2.8%, p<0.05). Activated GPIIb/IIIa was not significantly changed (13.5% to 17.6%, p>0.05). Underlying disease, cardiovascular risk factors, concomitant medication including statin, and hsCRP were not related to the degree of P-selectin expression. Conclusion: Our data demonstrated that cilostazol treatment in addition to conventional anti-platelet therapy provides more effective suppression of platelet P-selectin expression in patients with relatively high platelet activity.

Original languageEnglish
Pages (from-to)230-236
Number of pages7
JournalKorean Journal of Internal Medicine
Volume19
Issue number4
DOIs
Publication statusPublished - 2004 Jan 1

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clopidogrel
P-Selectin
Platelet Activation
Aspirin
Blood Platelets
Therapeutics
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Unstable Angina
cilostazol

Keywords

  • Antiplatelet therapy
  • Coronary stent

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{5cd6a59ac29447168c23224177a86a62,
title = "Effects of cilostazol on platelet activation in coronary stenting patients who already treated with aspirin and clopidogrel",
abstract = "Background: A recent study has shown that triple anti-platelet therapy (cilostazol+clopidogrel+aspirin) resulted in a significantly lower restenosis rate after coronary stenting than did conventional therapy (clopidogrel+aspirin) . However, the anti-platelet effects of cilostazol, when combined with clopidogrel and aspirin, have not been evaluated. Methods: Low dose cilostazol (50 mg/BID) was given to 47 patients who had already been taking clopidogrel (75 mg/day) and aspirin (100 mg/day) for more than 1 month subsequent to coronary stenting due to AMI and unstable angina. Markers of platelet activation, P-selectin and activated GPIIb/IIIa on platelets, were measured at baseline and 2 weeks after cilostazol treatment. We empirically divided patients into tertiles (low, n=16; moderate, n=14; high group, n=17), according to the baseline P-selectin expression. We then performed a comparative assessment of the anti-platelet effects of cilostazol at baseline and after 2 weeks of cilosatzol administration. Results: P-selectin was significantly decreased after 2 weeks of cilostazol treatment in total patients (n=47, 3.2± 2.4{\%} to 2.0±1.9{\%}, p=0.03). This inhibition of P-selectin expression was mainly achieved in the moderate and high P-selectin groups (low group; 1.4±0.5 to 1.9±1.3{\%}, p>0.05, moderate group; 2.5±0.3 to 1.3±0.3{\%}, p<0.05, high group; 5.4±2.7 to 2.7±2.8{\%}, p<0.05). Activated GPIIb/IIIa was not significantly changed (13.5{\%} to 17.6{\%}, p>0.05). Underlying disease, cardiovascular risk factors, concomitant medication including statin, and hsCRP were not related to the degree of P-selectin expression. Conclusion: Our data demonstrated that cilostazol treatment in addition to conventional anti-platelet therapy provides more effective suppression of platelet P-selectin expression in patients with relatively high platelet activity.",
keywords = "Antiplatelet therapy, Coronary stent",
author = "Ahn, {Jeong Cheon} and Woohyuk Song and Kwon, {Jung Ah} and Park, {Chang Gyu} and Seo, {Hong Seog} and Oh, {Dong Joo} and Rho, {Young Moo}",
year = "2004",
month = "1",
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doi = "10.3904/kjim.2004.19.4.230",
language = "English",
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pages = "230--236",
journal = "Korean Journal of Internal Medicine",
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TY - JOUR

T1 - Effects of cilostazol on platelet activation in coronary stenting patients who already treated with aspirin and clopidogrel

AU - Ahn, Jeong Cheon

AU - Song, Woohyuk

AU - Kwon, Jung Ah

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Oh, Dong Joo

AU - Rho, Young Moo

PY - 2004/1/1

Y1 - 2004/1/1

N2 - Background: A recent study has shown that triple anti-platelet therapy (cilostazol+clopidogrel+aspirin) resulted in a significantly lower restenosis rate after coronary stenting than did conventional therapy (clopidogrel+aspirin) . However, the anti-platelet effects of cilostazol, when combined with clopidogrel and aspirin, have not been evaluated. Methods: Low dose cilostazol (50 mg/BID) was given to 47 patients who had already been taking clopidogrel (75 mg/day) and aspirin (100 mg/day) for more than 1 month subsequent to coronary stenting due to AMI and unstable angina. Markers of platelet activation, P-selectin and activated GPIIb/IIIa on platelets, were measured at baseline and 2 weeks after cilostazol treatment. We empirically divided patients into tertiles (low, n=16; moderate, n=14; high group, n=17), according to the baseline P-selectin expression. We then performed a comparative assessment of the anti-platelet effects of cilostazol at baseline and after 2 weeks of cilosatzol administration. Results: P-selectin was significantly decreased after 2 weeks of cilostazol treatment in total patients (n=47, 3.2± 2.4% to 2.0±1.9%, p=0.03). This inhibition of P-selectin expression was mainly achieved in the moderate and high P-selectin groups (low group; 1.4±0.5 to 1.9±1.3%, p>0.05, moderate group; 2.5±0.3 to 1.3±0.3%, p<0.05, high group; 5.4±2.7 to 2.7±2.8%, p<0.05). Activated GPIIb/IIIa was not significantly changed (13.5% to 17.6%, p>0.05). Underlying disease, cardiovascular risk factors, concomitant medication including statin, and hsCRP were not related to the degree of P-selectin expression. Conclusion: Our data demonstrated that cilostazol treatment in addition to conventional anti-platelet therapy provides more effective suppression of platelet P-selectin expression in patients with relatively high platelet activity.

AB - Background: A recent study has shown that triple anti-platelet therapy (cilostazol+clopidogrel+aspirin) resulted in a significantly lower restenosis rate after coronary stenting than did conventional therapy (clopidogrel+aspirin) . However, the anti-platelet effects of cilostazol, when combined with clopidogrel and aspirin, have not been evaluated. Methods: Low dose cilostazol (50 mg/BID) was given to 47 patients who had already been taking clopidogrel (75 mg/day) and aspirin (100 mg/day) for more than 1 month subsequent to coronary stenting due to AMI and unstable angina. Markers of platelet activation, P-selectin and activated GPIIb/IIIa on platelets, were measured at baseline and 2 weeks after cilostazol treatment. We empirically divided patients into tertiles (low, n=16; moderate, n=14; high group, n=17), according to the baseline P-selectin expression. We then performed a comparative assessment of the anti-platelet effects of cilostazol at baseline and after 2 weeks of cilosatzol administration. Results: P-selectin was significantly decreased after 2 weeks of cilostazol treatment in total patients (n=47, 3.2± 2.4% to 2.0±1.9%, p=0.03). This inhibition of P-selectin expression was mainly achieved in the moderate and high P-selectin groups (low group; 1.4±0.5 to 1.9±1.3%, p>0.05, moderate group; 2.5±0.3 to 1.3±0.3%, p<0.05, high group; 5.4±2.7 to 2.7±2.8%, p<0.05). Activated GPIIb/IIIa was not significantly changed (13.5% to 17.6%, p>0.05). Underlying disease, cardiovascular risk factors, concomitant medication including statin, and hsCRP were not related to the degree of P-selectin expression. Conclusion: Our data demonstrated that cilostazol treatment in addition to conventional anti-platelet therapy provides more effective suppression of platelet P-selectin expression in patients with relatively high platelet activity.

KW - Antiplatelet therapy

KW - Coronary stent

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U2 - 10.3904/kjim.2004.19.4.230

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JF - Korean Journal of Internal Medicine

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