Current antiplatelet therapy in acute coronary syndrome have a focus on the dual antiplatelet therapy including aspirin and clopidogrel. However, the patient's drug resistance of aspirin and clopidogrel is the important cause of poor clinical prognosis. Therefore, recently, clinical research about the triple antiplatelet therapy including cilostazol is actively conducted. But, clinical research about triple antiplatelet therapy for acute myocardial infarction is inadequate situation, and the ideal duration of triple antiplatelet therapy has been actively discussed. Therefore, we try to evaluate the clinical outcomes of triple antiplatelet therapy in acute myocardial infarction patients undergoing percutaneous intervention with drug eluting stent compared with dual antiplatelet therapy and investigate ideal duration of triple antiplatelet therapy through this research.

Brief Title

Efficacy and Safety of Adjunctive Cilostazol in Acute Myocardial Infarction Patients

Official Title

Randomized, Prospective , Open Label, Phase 4 Trial of Efficacy and Safety of Adjunctive Cilostazol in Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention With Drug-eluting Stent

Brief Summary

Current antiplatelet therapy in acute coronary syndrome have a focus on the dual antiplatelet<br /> therapy including aspirin and clopidogrel. However, the patient's drug resistance of aspirin<br /> and clopidogrel is the important cause of poor clinical prognosis. Therefore, recently,<br /> clinical research about the triple antiplatelet therapy including cilostazol is actively<br /> conducted. But, clinical research about triple antiplatelet therapy for acute myocardial<br /> infarction is inadequate situation, and the ideal duration of triple antiplatelet therapy has<br /> been actively discussed. Therefore, we try to evaluate the clinical outcomes of triple<br /> antiplatelet therapy in acute myocardial infarction patients undergoing percutaneous<br /> intervention with drug eluting stent compared with dual antiplatelet therapy and investigate<br /> ideal duration of triple antiplatelet therapy through this research.

Detailed Description

Drug-eluting stents (DES) have drastically changed the landscape of percutaneous coronary
intervention (PCI), with significant reductions in the angiographic restenosis rate and need
for repeated revascularization. However, several studies showed that DES is associated with a
higher incidence of in-stent thrombosis compared with bare metal stents. Therefore, the
latest guideline for antiplatelet therapy after PCI with DES suggests that the dual
antiplatelet therapy (aspirin plus clopidogrel) be administered for at least 12 months.But is
it enough for high-risk patients? Some studies showed that as many as 50% of the patients who
received PCI did not react positively to aspirin or clopidogrel.Furthermore, there is
increased platelet activity in acute coronary syndrome, especially in acute myocardial
infarction (AMI). compared with aspirin or clopidogrel.A recent study suggested that
cilostazol could ameliorate platelet responsiveness to clopidogrel in patients who underwent
primary PCI. Furthermore, some other studies showed that the administration of cilostazol
after PCI could significantly lower the incidence of in-stent restenosis. Therefore, the
present study is designed to evaluate the safety and efficacy of additional administration of
cilostazol with aspirin and clopidogrel in a real-world cardiology practice among patients
presenting with AMI who received primary PCI with DES.

Outcome Measures

Outcome measures are the tests that investigators perform to prove whether or not a treatment being tested in a clinical trial is having any effect.