Cilostazol and outcome in outpatients with peripheral artery disease

Thromb Res. 2014 Aug;134(2):331-5. doi: 10.1016/j.thromres.2014.05.040. Epub 2014 Jun 6.

Abstract

Background: Cilostazol increases the walking distance in patients with intermittent claudication, but there is scarce evidence of any effect on the risk for subsequent ischemic events, bleeding or death.

Patients and methods: We used data from the FRENA Registry to compare the clinical outcome in stable outpatients with intermittent claudication, according to the use of cilostazol.

Results: As of January 2013, 1,317 patients with intermittent claudication were recruited in FRENA, of whom 191 (14.5%) received cilostazol. Over a mean follow-up of 18months, 39 patients developed myocardial infarction, 23 ischemic stroke, 20 underwent limb amputation, 15 had major bleeding and 70 died. There were no significant differences in the rate of subsequent ischemic events, major bleeding or death between patients receiving or not receiving cilostazol. On multivariate analysis, the use of cilostazol had no influence on the risk for subsequent myocardial infarction (hazard ratio [HR]: 0.97; 95% CI: 0.33-20.8), ischemic stroke (HR: 1.46; 95% CI: 0.48-4.43), limb amputation (HR: 0.34; 95% CI: 0.04-20.6), major bleeding (HR: 1.52; 95% CI: 0.33-7.09) or death (HR: 0.90; 95% CI: 0.40-20.0).

Conclusions: In stable outpatients with intermittent claudication, the use of cilostazol was not associated with increased rates of subsequent ischemic events, major bleeding or death.

Keywords: Cilostazol; Intermittent claudication; Outcome; Safety.

MeSH terms

  • Aged
  • Cilostazol
  • Female
  • Fibrinolytic Agents / adverse effects*
  • Fibrinolytic Agents / therapeutic use
  • Hemorrhage / chemically induced
  • Humans
  • Intermittent Claudication / drug therapy*
  • Male
  • Middle Aged
  • Myocardial Infarction / chemically induced
  • Outpatients
  • Peripheral Arterial Disease / drug therapy*
  • Phosphodiesterase 3 Inhibitors / adverse effects*
  • Phosphodiesterase 3 Inhibitors / therapeutic use
  • Registries
  • Stroke / chemically induced
  • Tetrazoles / adverse effects*
  • Tetrazoles / therapeutic use
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Phosphodiesterase 3 Inhibitors
  • Tetrazoles
  • Cilostazol