aspirin + clopidogrel + cilostazol

Aspirin + clopidogrel + cilostazol is a triple antiplatelet therapy combining three small molecule agents with distinct mechanisms of action. Aspirin irreversibly inhibits cyclooxygenase-1 (COX-1), reducing thromboxane A2 production and platelet aggregation. Clopidogrel is a prodrug that irreversibly inhibits the P2Y12 subtype of ADP receptor on platelets, preventing activation and aggregation. Cilostazol selectively and reversibly inhibits phosphodiesterase 3 (PDE3), increasing intracellular cAMP in platelets and vascular smooth muscle cells, leading to inhibition of platelet aggregation, vasodilation, anti-inflammatory effects, and inhibition of vascular smooth muscle proliferation[7]. This combination has been studied for secondary prevention after percutaneous coronary intervention (PCI) in acute coronary syndromes as well as for stroke prevention in high-risk patients. Clinical trials have shown that adding cilostazol to standard dual antiplatelet therapy with aspirin and clopidogrel reduces the incidence of major adverse cardiovascular events without significantly increasing bleeding risk compared to dual therapy alone[2][5][3].

Other names

Intensive antiplatelet therapyTriple antiplatelet therapy