Premature Ventricular Contractions (PVCs) Induced by Administration of Cilostazol after Myocardial Infarction

Cilostazol is a phosphodiesterase III inhibitor, which was approved by FDA (food and drug administration) for intermittent claudication in 1999. What made it known to cardiologists is the Cilostazol for Restenosis Trial (CREST), in which cilostazol was shown to significantly lower binary restenosis rate. Here we reported one case of acquired premature ventricular contractions (PVCs) during taking cilostazol. A 68-year-old male patient was diagnosed acute myocardial infarction and given percutaneous coronary intervention (PCI). It turned out there was thrombi in the distal right coronary artery. The patient was discharged taking cilostazol (100mg Bid) together with aspirin and clopidogrel. On follow-up, there were PVCs coming up (more than 27000 beats in 24-hour electrocardiography) and cilostazol was discontinued afterwards. After taking metoprolol (25 mg, Tid) for one week, the PVCs were decreased significantly, 600 beats/24 hours. In our case, the PVCs are obviously related to cilostazol and probably the safety of cilostazol in patients having a history of myocardial infarction or malignant arrhythmias should be reevaluated.