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首页> 外文期刊>The annals of pharmacotherapy >Use of cilostazol in percutaneous coronary interventions [El uso de Cilostazol en la Intervención Coronaria Percutánea]
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Use of cilostazol in percutaneous coronary interventions [El uso de Cilostazol en la Intervención Coronaria Percutánea]

机译：西洛他唑在经皮冠状动脉介入治疗中的应用[西洛他唑在经皮冠状动脉介入治疗中的应用]

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OBJECTIVE: To evaluate the addition of cilostazol to standard dual antiplatelet therapy (DAT) with aspirin and clopidogrel in patients receiving coronary stenting. DATA SOURCES: Relevant information was identified through a search of MEDLINE (1966-November 2011), International Pharmaceutical Abstracts (1960-2011), and Cochrane Databases (publications archived until November 2011) using the terms cilostazol, percutaneous coronary intervention, triple therapy, and antiplatelet agents. STUDY SELECTION AND DATA EXTRACTION: English-language prospective and retrospective studies, including registry data in adults, were eligible for inclusion if triple therapy with cilostazol was compared with DAT with aspirin and clopidogrel in patients undergoing percutaneous coronary intervention (PCI) with stenting. Article bibliographies were also reviewed. DATA SYNTHESIS: Cilostazol uniquely possesses antiproliferative properties in addition to its antiplatelet effects. Several prospective and retrospective clinical trials evaluated it as a third agent in standard antiplatelet regimens after PCI with both bare metal and drug-eluting stents. Both angiographic and clinical outcomes, including major adverse cardiac events (MACEs), have been improved with the addition of cilostazol to DAT in most trials, without increasing bleeding risk. Higher-risk patients, such as elderly individuals and patients with diabetes, long lesions, or small vessels, seem to benefit the most from triple therapy. Patients who are poor responders to clopidogrel also appear to benefit from the addition of cilostazol by improving platelet reactivity with standard DAT. CONCLUSIONS: Triple therapy with cilostazol has been shown to reduce MACEs by providing increased inhibition of platelet aggregation and reducing the rates of instent thrombosis compared to DAT without increasing the risk of bleeding complications. Further studies are needed to identify proper patient selection based on risk factors for the addition of cilostazol. Additionally, studies comparing cilostazol with newer antiplatelet therapies, such as prasugrel and ticagrelor, are needed.
机译：目的：评估在接受冠状动脉支架置入术的患者中，在阿司匹林和氯吡格雷的标准双重抗血小板治疗（DAT）中加入西洛他唑。数据来源：通过搜索MEDLINE（1966年-2011年11月），International Pharmaceutical Abstracts（1960-2011年）和Cochrane数据库（出版物存档至2011年11月），使用西洛他唑，经皮冠状动脉介入治疗，三联疗法，和抗血小板药。研究的选择和数据提取：如果对接受了支架置入术的经皮冠状动脉介入治疗（PCI）的患者进行西洛他唑三联疗法与阿司匹林和氯吡格雷DAT的比较，则英语前瞻性和回顾性研究（包括成人注册表数据）可以纳入研究。文章书目也进行了审查。数据合成：西洛他唑除具有抗血小板作用外，还具有独特的抗增殖特性。几项前瞻性和回顾性临床试验将裸金属支架和药物洗脱支架在PCI后作为标准抗血小板方案的第三种药物进行了评估。在大多数试验中，在DAT中添加西洛他唑可改善包括主要不良心脏事件（MACE）在内的血管造影和临床结果，而不会增加出血风险。高危患者，例如老年人和患有糖尿病，长病变或小血管的患者，似乎从三联疗法中受益最大。对氯吡格雷反应较弱的患者似乎也可以通过增加与标准DAT的血小板反应性而从西洛他唑中获益。结论：与DAT相比，西洛他唑三联疗法通过增加对血小板聚集的抑制作用和降低支架内血栓形成率而降低了MACE，而没有增加出血并发症的风险。需要进一步的研究以根据增加西洛他唑的危险因素确定合适的患者选择。此外，还需要将西洛他唑与较新的抗血小板疗法（如普拉格雷和替卡格雷）进行比较。

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