Cilostazol to overcome high on-treatment platelet reactivity in korean patients treated with clopidogrel and calcium-channel blocker.

urrent oral antiplatelet therapy mainly targets the inhibition of cyclooxygenase-1 (COX-1) and the P2Y12 receptor in patients with acute coronary syndrome (ACS) and those treated with percutaneous coronary intervention (PCI).1 Despite proven clinical efficacy, the persistent ischemic event occurrence (≈10%) suggests that dual antiplatelet therapy (DAPT) has reached a ceiling in its effect in attenuating thrombotic events and that some ischemic events are mediated by other pathways (non-COX-1 and non-P2Y12). However, the addition of inhibitors of the platelet thrombin receptor2 or coagulation factor3 to DAPT has not been clearly demonstrated to be effective in reducing ischemic event occurrence and has been associated with increased bleeding risk.