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Bivalirudin plus loading dose of cilostazol-based triple-antiplatelet in treatment of non-ST-elevation myocardial infarction following percutaneous coronary intervention

Authors Wang M, Zhang GR, Wang YL, Zhou K, Liu T, Zhang Y, Guo AJ, An Y, Zhang XD, Li YJ

Received 17 April 2015

Accepted for publication 11 August 2015

Published 28 September 2015 Volume 2015:11 Pages 1469—1473

DOI https://doi.org/10.2147/TCRM.S86799

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Deyun Wang

Mei Wang, Guoru Zhang, Yaling Wang, Kun Zhou, Tao Liu, Yang Zhang, Anjun Guo, Yu An, Xiaodan Zhang, Yongjun Li

Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China

Objective: To study the effect of bivalirudin plus loading dose of cilostazol-based triple-antiplatelet therapy strategy in patients undergoing percutaneous coronary intervention (PCI).
Methods: One hundred and fifty-three patients with non-ST-segment elevation myocardial infarction who underwent PCI were divided into control group and cilostazol group. Patients in control group were given aspirin and clopidogrel and those in cilostazol group were given aspirin, clopidogrel, and cilostazol once 2 hours before PCI and for 30 days after PCI. Bivalirudin was given to all patients before and during the PCI.
Results: After PCI, the Thrombolysis In Myocardial Infarction myocardial perfusion grade (TMPG) III in cilostazol group was higher than that in control group (89.19% versus 72.15%, P<0.05). At 30 days, the incidence of major adverse cardiac events was significantly lower in cilostazol group compared with that in control group (6.76% versus 17.72%, P<0.05). However, the rates of cardiac death, nonfatal reinfarction, target vessel revascularization, new congestive heart failure, and subacute stent thrombosis did not significantly differ between the two groups. In addition, the rates of minor or major bleeding or thrombocytopenia did not significantly differ between the two groups.
Conclusion: Bivalirudin plus loading dose of cilostazol-based triple-antiplatelet therapy strategy in PCI increased TMPG III, decreased major adverse cardiac events, and did not increase the incidence of bleeding and thrombocytopenia.

Keywords: triple-antiplatelet therapy, bivalirudin, percutaneous coronary intervention

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