{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T19:47:28Z","timestamp":1782157648105,"version":"3.54.5"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T00:00:00Z","timestamp":1643932800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007219","name":"Natural Science Foundation of Shanghai","doi-asserted-by":"publisher","award":["17ZR1403700"],"award-info":[{"award-number":["17ZR1403700"]}],"id":[{"id":"10.13039\/100007219","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81800305"],"award-info":[{"award-number":["81800305"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cilostazol combined with P2Y<jats:sub>12<\/jats:sub> receptor inhibitor has been used as a substitute regimen for aspirin\u2010intolerant patients undergoing percutaneous coronary stent implantation on a small scale. Its exact impact on platelet functions and clinical benefits of aspirin\u2010intolerant patients is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Cilostazol combined with P2Y<jats:sub>12<\/jats:sub> receptor inhibitors could be used as a substitute antiplatelet regimen for aspirin\u2010intolerant patients undergoing percutaneous coronary stent implantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this multicenter prospective cohort trial, patients undergoing elective percutaneous coronary stent implantation were assigned to the cilostazol group (cilostazol plus P2Y<jats:sub>12<\/jats:sub> receptor inhibitors), based on aspirin intolerance criteria, or the aspirin group (aspirin plus P2Y<jats:sub>12<\/jats:sub> receptor inhibitors). Platelet PAC\u20101, CD62p, and vasodilator\u2010stimulated phosphoprotein phosphorylation (VASP\u2010P) were detected by flow cytometry. The primary endpoints were major adverse cardiovascular and cerebrovascular events (MACCE) including all\u2010cause death, acute myocardial infarction, emerging arrhythmia, nonfatal stroke, and heart failure. The secondary endpoints were the Bleeding Academic Research Consortium (BARC) bleeding events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and fifty\u2010four aspirin\u2010intolerant percutaneous coronary stent implantation patients and 154 matched aspirin\u2010tolerant patients from a total of 2059 percutaneous coronary stent implantation patients were enrolled. The relative activation level of PAC\u20101, CD62p, and platelet reaction index reflected by the VASP\u2010P test were similar in the two groups\u00a0(<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05). After 12 months of follow\u2010up, the incidence of all\u2010cause death was 1.9% in the cilostazol group\u00a0and 1.3% in the aspirin group (risk ratio [RR], 1.500; 95% confidence interval [CI], 0.254\u20138.852; <jats:italic>p<\/jats:italic>\u2009=\u20091.000); the incidence of acute myocardial infarction was\u00a00.6% in the cilostazol group\u00a0and\u00a01.3% in the aspirin group (RR, 0.500; 95% CI, 0.046\u20135.457; <jats:italic>p<\/jats:italic>\u2009=\u20091.000). No significant difference was seen in other MACCE events, or in any types of BARC bleeding events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cilostazol combined with P2Y<jats:sub>12<\/jats:sub> inhibitors was not inferior to aspirin\u2010based standard therapy\u00a0and could be used as a reasonable substitute antiplatelet regimen for aspirin\u2010intolerant patients undergoing percutaneous coronary stent implantation, but again with limitations, which required a larger sample and longer follow\u2010up to confirm its efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23787","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T20:48:58Z","timestamp":1644007738000},"page":"189-197","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cilostazol combined with P2Y<sub>12<\/sub> receptor inhibitors: A substitute antiplatelet regimen for 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