Dataset Information

Adjunctive cilostazol versus high maintenance dose of clopidogrel in patients with hyporesponsiveness to chronic clopidogrel therapy.

ABSTRACT:

Purpose

Whether addition of cilostazol is superior to increasing dose of clopidogrel in patients with hyporesponsiveness to chronic clopidogrel therapy is unknown.

Materials and methods

We studied 73 patients with hyporesponsiveness to clopidogrel on standard dual antiplatelet therapy for more than 2 weeks. Clopidogrel hyporesponsiveness was defined as percent inhibition of P2Y12 reaction units (PRU) <30% on VerifyNow P2Y12 assay. Patients were randomly assigned to increased dose of clopidogrel (aspirin 100 mg+clopidogrel 150 mg daily: group A, n=38) or to receiving additional cilostazol (aspirin 100 mg+clopidogrel 75 mg+cilostazol 100 mg bid daily: group B, n=35).

Results

Baseline percent inhibition of PRU and PRU was similar between 2 groups (13.0 ± 10.2% versus 11.8 ± 9.7%, p = 0.61, and 286.3 ± 54.7 versus 295.7 ± 53.7, p=0.44, respectively). At follow-up, percent inhibition of PRU was higher and PRU was lower significantly in group B than in group A (38.5 ± 17.9% versus 28.3 ± 16.6%, p=0.02, and 207.3 ± 68.2 versus 241.3 ± 76.7, p=0.050, respectively). Among those still showing hyporesponsiveness to clopidogrel at follow-up (21 patients in group A, 10 patients in group B), 12 patients completed further crossover study. Compared to the baseline, magnitude of change in percent inhibition of PRU and PRU showed an improved tendency after the crossover (from 2.7 ± 8.7% to 15.8 ± 18.4%, p=0.08, and from -18.6 ± 58.0 to -61.9 ± 84.3, p=0.08).

Conclusion

Adjunctive cilostazol improved clopidogrel responsiveness better than the higher maintenance dose of clopidogrel in hyporesponsive patients with chronic clopidogrel therapy.

SUBMITTER: Lee GY

PROVIDER: S-EPMC3521288 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature

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Publications

Adjunctive cilostazol versus high maintenance dose of clopidogrel in patients with hyporesponsiveness to chronic clopidogrel therapy.

Lee Ga Yeon GY Hahn Joo-Yong JY Lee Soo-Youn SY Kim Hee-Jin HJ Kim Jun Hyung JH Lee Sang-Yup SY Song Young Bin YB Choi Seung-Hyuk SH Choi Jin-Ho JH Gwon Hyeon-Cheol HC

Yonsei medical journal 20130101 1

<h4>Purpose</h4>Whether addition of cilostazol is superior to increasing dose of clopidogrel in patients with hyporesponsiveness to chronic clopidogrel therapy is unknown.<h4>Materials and methods</h4>We studied 73 patients with hyporesponsiveness to clopidogrel on standard dual antiplatelet therapy for more than 2 weeks. Clopidogrel hyporesponsiveness was defined as percent inhibition of P2Y12 reaction units (PRU) <30% on VerifyNow P2Y12 assay. Patients were randomly assigned to increased dose ...[more]

PMID: 23225796

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Dataset Information

Adjunctive cilostazol versus high maintenance dose of clopidogrel in patients with hyporesponsiveness to chronic clopidogrel therapy.

Purpose

Materials and methods

Results

Conclusion

Publications

Adjunctive cilostazol versus high maintenance dose of clopidogrel in patients with hyporesponsiveness to chronic clopidogrel therapy.

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