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Cilostazol reduces restenosis in diabetics treated with drug-eluting stents
Monday, 29 November 1999 19:00 | 
| Medicexchange News - Medicexchange News |
Treatment with cilostazol following implantation of a drug-eluting stent helps prevent late restenosis in diabetic patients treated with standard antiplatelet therapy, according to a report in the Journal of the American College of Cardiology.
"Treatment with cilostazol following implantation of a drug-eluting stent helps prevent late restenosis in diabetic patients treated with standard antiplatelet therapy, according to a report in the Journal of the American College of Cardiology for March 25.
Previous research has shown that cilostazol, a phosphodiesterase III inhibitor, can reduce neointimal hyperplasia and restenosis after implantation of a bare metal stent. Whether this agent provides similar benefits after drug-eluting stenting in diabetics was not known.
In the DECLARE-DIABETES trial, Dr. Seong-Wook Park, from the University of Ulsan College of Medicine in Seoul, Korea, and colleagues assessed late restenosis in 200 diabetics who underwent implantation of a drug-eluting stent and were randomized to receive aspirin and clopidogrel therapy with or without cilostazol for six months.
Cilostazol treatment was associated with significantly lower rates of in-stent late loss, in-segment late loss, six-month in-segment restenosis, and nine-month target lesion revascularization.
The findings also indicate a trend toward lower rates of major adverse cardiovascular events, MI, and death with use of cilostazol.
On multivariate analysis, use of sirolimus-eluting stent and treatment with cilostazol were both strong independent predictors of reduced rates of restenosis and target lesion revascularization.
These findings support the use of cilostazol as a means of reducing late restenosis and improving clinical outcomes in diabetics who undergo percutaneous coronary intervention with a drug-eluting stent, the investigators conclude."
Previous research has shown that cilostazol, a phosphodiesterase III inhibitor, can reduce neointimal hyperplasia and restenosis after implantation of a bare metal stent. Whether this agent provides similar benefits after drug-eluting stenting in diabetics was not known.
In the DECLARE-DIABETES trial, Dr. Seong-Wook Park, from the University of Ulsan College of Medicine in Seoul, Korea, and colleagues assessed late restenosis in 200 diabetics who underwent implantation of a drug-eluting stent and were randomized to receive aspirin and clopidogrel therapy with or without cilostazol for six months.
Cilostazol treatment was associated with significantly lower rates of in-stent late loss, in-segment late loss, six-month in-segment restenosis, and nine-month target lesion revascularization.
The findings also indicate a trend toward lower rates of major adverse cardiovascular events, MI, and death with use of cilostazol.
On multivariate analysis, use of sirolimus-eluting stent and treatment with cilostazol were both strong independent predictors of reduced rates of restenosis and target lesion revascularization.
These findings support the use of cilostazol as a means of reducing late restenosis and improving clinical outcomes in diabetics who undergo percutaneous coronary intervention with a drug-eluting stent, the investigators conclude."
