Cilostazol and Endothelial Progenitor Cell

Adjunctive Cilostazol to Dual Antiplatelet Therapy to Enhance Mobilization of Endothelial Progenitor Cell in Patients With Acute Myocardial Infarction: A Randomized, Placebo-controlled ACCEL-EPISODE Trial

To assess impact of adjunctive cilostazol on endothelial progenitor cell (EPC) mobilization in patients with acute myocardial infarction (To reveal the role of cilostazol in up-regulation of EPC count)

Primary endpoint: % Change of EPC count

Secondary endpoints:

1. Changes of ADP/AA/collagen-induced PFT
2. Changes of lipid profile and high sensitivity-C-reactive protein
3. Change of TEG measurements
4. Change of PWV
5. Predictors of EPC count (baseline and 1-month)
6. ischemic (CV death, MI & stroke) and bleeding events (BARC)

Inclusion Criteria:

• naïve AMI
• undergoing successful coronary stent implantation

Exclusion Criteria:

• high-risk patients for thrombotic event;
• a history of active bleeding or bleeding diatheses;
• contraindication to antiplatelet therapy;
• hemodynamic or electrical instability;
• oral anticoagulation therapy;
• left ventricular ejection fraction < 30%;
• leukocyte count < 3,000/mm3 and/or platelet count < 100,000/mm3;
• AST or ALT > 3 times the respective the upper limit;
• serum creatinine level > 3.5 mg/dL;
• stroke within 3 months;
• pregnancy;
• non-cardiac disease with a life expectancy < 1 year;
• any patients not tolerable or suitable for coronary intervention; and
• inability to follow the protocol