Efficacy and safety of cilostazol-based triple antiplatelet therapy compared with clopidogrel-based dual antiplatelet therapy in patients with acute ST-elevation myocardial infarction undergoing percutaneous coronary intervention: A multicenter, randomized, open-label, phase 4 trial
Authors' conclusion
The addition of cilostazol to DAT did not reduce the incidence of 1-year MACEs compared with DAT alone.
Study context
- Population
- Patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) with drug-eluting stents, 15 PCI centres in South Korea and China
- Participants
- 985 patients
- Comparison
- Cilostazol-based triple antiplatelet therapy (TAT) vs clopidogrel-based dual antiplatelet therapy (DAT)
- Primary endpoint
- MACE:
- All-cause death
- Recurrent MI
- Stroke
- Repeat revascularization
- Follow-up
- 1 year
Methodological detailsmulticentre, open-label
- Multicentre
- Open-label
Primary result
As reported in the abstract
Each group vs DATHazard ratio (95% CI)P value
TAT 1M
1.302(0.792–2.141)
P = 0.297TAT 6M
1.358(0.829–2.225)
P = 0.225Safety
In-hospital bleeding events
- More bleeding events with TAT than DAT (1.3% vs 4.7% vs 2.6%)
- P = 0.029
- No significant differences in major bleeding events
Headaches
- Higher incidence of headaches with TAT (0% vs 1.6% vs 2.6%)
- P = 0.020
Original publication
Efficacy and safety of cilostazol-based triple antiplatelet therapy compared with clopidogrel-based dual antiplatelet therapy in patients with acute ST-elevation myocardial infarction undergoing percutaneous coronary intervention: A multicenter, randomized, open-label, phase 4 trial. Am Heart J. Published 3 July 2023. doi:10.
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