Comparison of cilostazol versus ticlopidine following coronary stenting in patients with coronary heart disease: A meta-analysis of randomized controlled trials

Abstract

Previous studies have shown that the combination of cilostazol and aspirin may be a more effective regimen than ticlopidine plus aspirin in the prevention of late restenosis and acute or subacute stent thrombosis following coronary stenting; however, individually published results are inconclusive. The aim of this meta-analysis was to compare the differences in late restenosis and stent thrombosis between cilostazol plus aspirin and ticlopidine plus aspirin for patients with coronary heart disease (CHD) following coronary stenting. A literature search of Pubmed, Embase, Web of Science and Chinese BioMedicine (CBM) databases was conducted from 1998 to March 1, 2013 and statistical analysis was performed using Stata statistical software, version 12.0. Twelve randomized controlled trials were included in the study, with a total of 2,708 patients with CHD following coronary stenting. The patient population comprised 1,371 patients treated with cilostazol plus aspirin and 1,337 patients treated with ticlopidine plus aspirin. The meta-analysis showed that cilostazol plus aspirin demonstrated a lower rate of restenosis than ticlopidine plus aspirin [odds ratio (OR)=0.83, 95% confidence interval (CI)=0.69–0.99, P=0.047]. A significant difference was also observed in the average percent diameter stenosis between cilostazol plus aspirin and ticlopidine plus aspirin [standardized weight difference (SMD)= −0.57, 95% CI=−0.92, −0.23, P=0.001). However, there were no significant differences in the rates of acute or subacute stent thrombosis between cilostazol plus aspirin and ticlopidine plus aspirin. The present meta-analysis suggests that cilostazol plus aspirin may result in a lower restenosis rate and percent diameter stenosis than ticlopidine plus aspirin for patients with CHD following coronary stenting.

Update on Cilostazol: A Critical Review of Its Antithrombotic and Cardiovascular Actions and Its Clinical Applications

“…A meta‐analysis of 12 RCTs comprising 2708 patients with CAD following coronary stenting indicated that cilostazol plus aspirin (n = 1371) conferred a reduced restenosis rate (OR, 0.83; P = .047) and a lower mean percent diameter stenosis than ticlopidine plus aspirin (n = 1337; P = .001) 143 . However, the rates of acute or subacute stent thrombosis were not significantly different between cilostazol plus aspirin and ticlopidine plus aspirin.…”

Impact of a medical supply bulk-buy program on treatment of patients with coronary artery disease in China: A single-center study

“…Although many efforts have recently been introduced to improve people's health in China, the vast territory and unbalanced economic development have limited these efforts, especially in patients with cardiovascular disease [1][2][3]. As one of the most serious diseases threatening human health, coronary heart disease (CHD) consumes vast medical resources [4,5]. One of the key treatments for CHD is percutaneous transluminal coronary intervention (PCI), however, this treatment is costly because of the expensive stents and balloons used for this procedure, which imposes a high financial burden for patients and society.…”