Pharmacodynamic effect of cilostazol plus standard clopidogrel versus double-dose clopidogrel in patients with type 2 diabetes undergoing percutaneous coronary intervention

Young Hoon Jeong, Udaya S. Tantry, Yongwhi Park, Tae Jung Kwon, Jeong Rang Park, Seok Jae Hwang, Kevin P. Bliden, Eun Ha Koh, Choong Hwan Kwak, Jin Yong Hwang, Sunjoo Kim, Paul A. Gurbel

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Abstract

OBJECTIVE - To determine the effect of adding cilostazol (100 mg b.i.d.) to standard-dose clopidogrel (75 mg/d) (TRIPLE) compared with double-dose clopidogrel (150 mg/d) (DOUBLE) and the influence of the cytochrome P450 ( CYP2C19*2/*3 , CYP3A5*3) and ATP-binding cassette subfamily B1 (ABCB1 C3435T) genetic polymorphisms in type 2 diabetes (T2DM) patients. RESEARCH DESIGN AND METHODS - T2DM patients were treated with TRIPLE (n = 41) or DOUBLE (n = 39) after percutaneous coronary intervention. Conventional aggregometry and VerifyNow were performed at baseline and at 30 days. The primary end point was absolute change in 20-μM ADP-induced maximal platelet aggregation (ΔMPA20) between baseline and switching values. RESULTS - TRIPLE versus DOUBLE showed greater ΔMPA20 (22.9 ± 11.6 vs.12.7 ± 15.5%; difference, 10.2% [95% CI 4.2-16.3]; P < 0.001). Carriage of one (β coefficient, -5.4%; P = 0.162) and two CYP2C19 loss-of-function allele(s) (-8.3%; P = 0.007) were associated with lower ΔMPA20 in DOUBLE - treated patients, but not in TRIPLE-treated patients. CONCLUSIONS - Among T2DM patients, adding cilostazol achieves greater platelet inhibition compared with clopidogrel (150 mg/d), which is not influenced by genetic polymorphisms.

Original languageEnglish (US)
Pages (from-to)2194-2197
Number of pages4
JournalDiabetes care
Volume35
Issue number11
DOIs
StatePublished - Nov 1 2012

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ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Jeong, Y. H., Tantry, U. S., Park, Y., Kwon, T. J., Park, J. R., Hwang, S. J., Bliden, K. P., Koh, E. H., Kwak, C. H., Hwang, J. Y., Kim, S., & Gurbel, P. A. (2012). Pharmacodynamic effect of cilostazol plus standard clopidogrel versus double-dose clopidogrel in patients with type 2 diabetes undergoing percutaneous coronary intervention. Diabetes care, 35(11), 2194-2197. https://doi.org/10.2337/dc11-2351