Treatment with cilostazol improves clinical outcome after endovascular therapy in hemodialysis patients with peripheral artery disease.

Abstract

BACKGROUND:

Cilostazol has been reported to prevent atherosclerotic events in the general population. However, data have been limited whether there are beneficial effects of cilostazol use on long-term clinical outcomes after endovascular therapy in hemodialysis (HD) patients with peripheral artery disease (PAD).

METHODS AND RESULTS:

This study consisted of 595 HD patients undergoing endovascular therapy for a clinical diagnosis of PAD. They were divided into two groups: patients receiving 100mg cilostazol twice daily in conjunction with standard therapy (n=249 patients, cilostazol group) and those not administered cilostazol (n=346 patients, control group). A propensity score analysis was performed to adjust for baseline differences between the two groups. The propensity score-adjusted 10-year event-free survival rate from major adverse cardiovascular events (MACE) was significantly higher in the cilostazol group than in the control group [58.6% vs. 43.7%, hazard ratio (HR) 0.57; 95% confidence interval (CI) 0.41-0.79; p=0.0010]. Notably, the adjusted stroke-free rate was significantly higher in the cilostazol group than in the control group (81.6% vs. 74.7%; HR=0.48; 95% CI, 0.25-0.92, p=0.028). Even after adjusting for other confounders, treatment with cilostazol was an independent predictor for prevention of MACE and stroke (p=0.0028 and p=0.039, respectively).

CONCLUSIONS:

Cilostazol administration improves long-term clinical outcomes including prevention of MACE and stroke after endovascular therapy in HD patients with PAD.

• Authors: Hideki Ishii, Toru Aoyama, Hiroshi Takahashi, Yoshitaka Kumada, Daisuke Kamoi, Takashi Sakakibara, Norio Umemoto, Susumu Suzuki, Akihito Tanaka, Yasuhiko Ito, Toyoaki Murohara
• Journal: Journal of cardiology (J Cardiol) Vol. 67 Issue 2 Pg. 199-204 (Feb 2016) ISSN: 1876-4738 [Electronic] Netherlands
• PMID: 26074442 (Publication Type: Journal Article)
• Copyright: Copyright © 2015. Published by Elsevier Ltd.

Chemical References

• Tetrazoles
• Vasodilator Agents
• Cilostazol

Topics

• Aged
• Cilostazol
• Disease-Free Survival
• Female
• Humans
• Kidney Diseases (complications, therapy)
• Male
• Middle Aged
• Peripheral Arterial Disease (drug therapy, etiology, surgery)
• Propensity Score
• Proportional Hazards Models
• Renal Dialysis
• Stroke (prevention & control)
• Tetrazoles (therapeutic use)
• Vasodilator Agents (therapeutic use)