Comparison of cilostazol and ticlopidine for one-month effectiveness and safety after elective coronary stenting

Purpose: To compare the oral antiplatelets, phosphodiesterase III inhibitor cilostazol and the thienopyridine ticlopidine, for one-month effectiveness and safety as an adjunctive therapy after coronary stenting. Methods: Published studies retrieved through Medline and other databases from 1966-2002. Meta-analyses evaluated effectiveness and adverse side effects for one-month administrations of aspirin plus cilostazol or aspirin plus ticlopidine therapy after coronary stenting. Major adverse cardiac events (MACE), stent-associated thrombosis or adverse side effects after coronary stenting were compared between the two study arms and expressed with the odds ratios (OR) specific for the individual studies and meta-analytic summary for OR. Results: Five clinical studies met the inclusion criteria, and 4 of these studies underwent meta-analysis. With regard to the comparison of the OR summary for MACE and stent-associated thrombosis for the clinical outcome, there were no statistical significant differences between aspirin plus cilostazol and aspirin plus ticlopidine. While, the incidence of adverse side effects tended to be lower, they were not statistically significant in patients with aspirin plus cilostazol. Conclusions: Our meta-analysis results indicated that there were no differences between cilostazol (plus aspirin) and ticlopidine (plus aspirin) with regard to effectiveness and safety for a one-month period when used as an adjunctive therapy after coronary stenting.