The effectiveness and safety of triple-antiplatelet treatment based on cilostazol for patients receiving percutaneous coronary intervention: a meta-analysis

Clinical Cardiology, 05/16/2012

The triple therapy is associated with a higher level of adverse drug events, including rash (OR: 2.45, 95% CI: 1.41–4.23, P = 0.001), gastrointestinal disorders (OR: 2.59, 95% CI: 1.26–5.30, P = 0.009), and drug discontinuation (OR: 3.80, 95% CI: 1.59–9.10, P = 0.003), but it has no difference in bleeding compared with the dual therapy (OR: 1.05, 95% CI: 0.71–1.55, P = 0.80).

Methods

  • Authors performed a meta–analysis based on 8 randomized controlled trials.
  • A total of 3332 patients to compare the effectiveness and safety of this triple therapy with traditional dual therapy (aspirin and clopidogrel).

Results

  • These findings suggested that the triple therapy is more effective than dual therapy in preventing restenosis (odds ratio [OR]: 0.52, 95% confidence interval [CI]: 0.40–0.66, P < 0.00001), maintaining minimal lumen diameter (OR: 0.15, 95% CI: 0.10–0.20, P < 0.00001), and avoiding target–vessel revascularization (OR: 0.62, 95% CI: 0.47–0.82, P = 0.001).
  • There is also no significant difference in major adverse cardiac and cerebrovascular events between the 2 therapies, except the smaller occurrence rate of target–lesion revascularization in the triple–therapy group (OR: 0.42, 95% CI: 0.26–0.69, P = 0.0005).

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