Temporary Adjunctive Cilostazol vs Clopidogrel Loading for ST-segment Elevation Acute Myocardial Infarction

Tanaka, Akihito; Ishii, Hideki; Shimizu, Masaki; Okumura, Satoshi; Jinno, Yasushi; Okada, Koji; Suzuki, Susumu; Inoue, Yosuke; Murohara, Toyoaki

doi:10.1007/s40256-013-0059-7

Cited by 4 publications

(6 citation statements)

References 24 publications

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“…It is established that several hypotensors, statins and anti-platelet drugs cause renal toxicity, particularly in aged patients with declined renal function. There are several anti-platelet treatments used to prevent stent thrombosis and reduce future ischemic events, aspirin being one important and common anti-platelet therapy (16). As one of the traditional non-steroid, anti-inflammatory drugs, aspirin intake may result in renal failure or aggravate renal dysfunction (17,18).…”

Section: Discussionmentioning

confidence: 99%

Delayed kidney injury following coronary angiography

Wang

Peng

Zhang

et al. 2016

Experimental and Therapeutic Medicine

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It is occasionally observed that patients without contrast-induced nephropathy (CIN) develop kidney injury within 1-6 months after coronary angiography (CAG), termed delayed CIN or delayed kidney injury (DKI) following CAG. The present study aimed to investigate the associated risk factors of delayed CIN and its possible pathogenesis. Subjects with CAG or coronary stenting from January 2008 to December 2009 were studied. A retrospective survey on DKI after CAG was conducted and the risk factors were analyzed. There were 436 cases receiving CAG with complete medical records enrolled in the present cohort, in which the DKI incidence was 7.1% (31/436). Patients with DKI after CAG exhibited lower hemoglobin (121.2±17.3 vs. 133.8±18.6 g/l), estimated glomerular filtration rate (eGFR; 66.4±30.2 vs. 71.9±28.6 ml/min), higher serum creatinine (110.9±43.2 vs. 91.7±37.6 µmol/l), higher rate of heart failure (22.6 vs. 5.4%) and 300 mg aspirin therapy (29 vs. 5.7%) compared with non-DKI patients (all P<0.05). However, no differences were observed in morbidities of diabetes, hypertension, hyperlipidemia and proteinuria, or in the treatments with angiotensin converting enzyme (ACE) inhibitors/angiotensin II receptor-1 blockers (ARBs), diuretics, statins and other anti-platelets between the two groups (P>0.05). Logistic regression revealed that anemia, heart failure and 300 mg aspirin intake were risk factors of DKI (P<0.05), while the contrast level, isotonic contrast, diabetes, ACE inhibitors/ARBs, eGFR and other factors were not associated with DKI (P>0.05). Heart dysfunction and 300 mg aspirin therapy may contribute to DKI after CAG, and iodinated contrast media administration is not a risk factor.

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Section: Discussionmentioning

confidence: 99%

Delayed kidney injury following coronary angiography

Wang

Peng

Zhang

et al. 2016

Experimental and Therapeutic Medicine

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“…The authors hypothesized that the substitution of cilostazol for clopidogrel loading in this population would reduce bleeding complications without compromising ischaemic outcomes. In fact, they found no difference in ischaemic or major bleeding outcomes between treatment groups [10]. Based on these data, the authors propose a potential role for cilostazol in the contemporary management of patients undergoing emergent percutaneous coronary intervention for STEMI.…”

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confidence: 91%

“…First approved for use in Japan in 1988, it has since been studied in a variety of vascular disorders, including peripheral arterial and cerebrovascular disease, and as an adjunct to existing antiplatelet agents in patients with coronary artery disease undergoing percutaneous coronary intervention. In the current edition of the journal, Tanaka et al [10] propose a novel indication for cilostazol, namely as a substitute for clopidogrel loading in patients presenting with STEMI.…”

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confidence: 99%

“…A change in clinical practice within the authors' institution in 2009 permitted the investigators to examine clinical outcomes in patients with STEMI treated with dual antiplatelet (aspirin and clopidogrel with a 300 mg clopidogrel loading dose) compared with those receiving triple antiplatelet therapy (aspirin, cilostazol, and clopidogrel, without a clopidogrel loading dose) [10]. The authors hypothesized that the substitution of cilostazol for clopidogrel loading in this population would reduce bleeding complications without compromising ischaemic outcomes.…”

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confidence: 99%

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Cilostazol in Acute Myocardial Infarction: New Tricks for an Old Drug?

Adamson

Cruden

2014

Am J Cardiovasc Drugs

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“…However, because peripheral arterial disease is frequently associated with coronary artery disease, it is important to investigate whether cilostazol is also cardio protective. Moreover, little information is available to determine the cardio protective effect of adjunctive cilostazol compared with clopidogrel alone in those patients (Tanaka et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Cardioprotective Effect of Cilostazol Versus Clopidogrel in Experimentallyinduced Myocardial Infarction in Male Albino Rats

Kamel

2015

Al-Azhar Journal of Pharmaceutical Sciences

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Antiplatelet agents remain the cornerstone treatment in patients with ischemic heart diseases, as they decrease the mortality as well as the recurrence of cardiovascular complications. This study aimed to assess and compare the possible cardioprotective effect of cilostazol, clopidogrel and their combination in experimentally induced myocardial ischemia/reperfusion (MI/R) in rats.In this study ninety-six rats were divided into six equal groups (each of 16 rats): group 1, control normal received the vehicle; group 2, sham-operated and received the vehicle; group 3 (MI/R-treated) where myocardial infarction was induced by left coronary artery ligation (LCAL) for 30 min, followed by 2 h. reperfusion; group 4 received cilostazol (20 mg/kg, p.o.); group 5 received clopidogrel (30 mg/kg, p.o.); group 6 received combination of both drugs in the same doses. In all treated groups (groups 4, 5 & 6), drugs were administered for 3days, then they were exposed to MI/R. Results of the present study revealed that MI/R injury induced a significant decrease in mean arterial blood pressure (MABP), increase in heart rate (HR), elevation in T-wave voltage along with increased infarct size, plasma cardiac troponin I (cTnI) level and tumor necrosis factor alpha (TNF-α) and heart content ofmalondialdehyde (MDA), consequently with reduction in heart tissue glutathione peroxidase (GPx) activity. Cilostazol, clopidogrel or their coadministration exerted cardioprotective effect manifested by significant reductions in the T-wave voltage, infarct size and cTnI level via enhancement of antioxidant capacity and prevention of inflammatory and oxidative stress cascades. Additionally, cilostazol increased the HDL and decreased the LDL levels. It could be concluded that cilostazol is an effective cardioprotective agentin treatment of myocardial infarction particularly when used as an adjuvant to clopidogrel.

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Temporary Adjunctive Cilostazol vs Clopidogrel Loading for ST-segment Elevation Acute Myocardial Infarction

Abstract: There was no significant difference in the incidence of major adverse cardiac events between temporary adjunctive cilostazol treatment and clopidogrel loading in ST-segment elevation acute myocardial infarction patients. Our findings suggest one potential of cilostazol.

Cited by 4 publications

References 24 publications

Delayed kidney injury following coronary angiography

Delayed kidney injury following coronary angiography

Cilostazol in Acute Myocardial Infarction: New Tricks for an Old Drug?

Cardioprotective Effect of Cilostazol Versus Clopidogrel in Experimentallyinduced Myocardial Infarction in Male Albino Rats

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