Prevention of restenosis by systemic drug therapy: back to the future?

In this issue of Circulation, 2 studies report a positive outcome in patients who received oral pharmacotherapy for the prevention of restenosis after stent placement. In the randomized, double-blind, placebo-controlled Cilostazol for Restenosis Trial (CREST) trial,1 patients were given cilostazol, a phosphodiesterase 3 inhibitor with antithrombotic2 and antiproliferative3 properties, for 6 months starting immediately after implantation of a bare-metal stent in a de novo target lesion. Minimal lumen diameter, the primary end point of this study, which comprised 705 patients, was larger among patients treated with cilostazol than among those who received placebo. Other angiographic but not clinical outcomes were also more favorable among patients assigned to the active treatment arm.