Abstract: AIM:To evaluate the efficacy and safety of the antiplatelet agent cilostazol combinated with clopidogrel in patients with acute coronary artery syndrome without ST-segment elevation(NSTE-ACS). METHODS:63 patients with NSTE-ACS were randomly divided into tow groups. Group A(n =31) received cilostazol (100 mg bid) plus clopidogrel (75 mg once daily), Group B(n =32) received aspirin (100 mg once daily) plus clopidogrel (75 mg once daily), the treatment course was 14 days. The expression and inhibition rates of platelet membrane glycoprotein (PAC-1 and CD62P)were measured by flow cytometry before anti-platelet therapy, 7 days and 14 days after initial therapy. The major adverse cardiac event and bleeding complication were monitored. RESULTS: There are lower expression rate at 7 days and 14 days after initial therapy than before therapy in both two groups(P <0. 01), the lowest at 14 days after initial therapy. The expression levels of PAC-1 or CD62 had no significant difference between two groups in the same time point(P <0. 05); Inhibition rates of PAC-1 or CD62 had also no significant difference beween two groups in the same time point (P >0. 05). Moreover, there was no statistically significant difference in occurrence rate of major adverse cardiac event (MACE) between these two groups(P <0. 05) while Group A had less hemorrhage complications than Group B (P < 0. 05). CONCLUSION:For patients with NSTEACS, anti-platelet efficiency of cilostazol plus clopidogrel are similar to aspirin plus clopidogrel whereas the previous is safer.

Key words: cilostazol, clopidogrel, f low cytometry, platelet membrane glycoprotein