The comparison of the effects of the cilostazol on the stiffness parameters in different arterial systems in the patients with peripheral arterial disease
Abstract
Objective/Aim
To determine the effect of cilostazol on arterial compliance, distensibilty, vascular stiffness and other vascular events through non-invasive methods in patients with stable IC/PAD.
Method
Twenty-nine patients (22 male, 7 female) who had been treated with cilostazol 100 mg twice daily during six month were included in the study. Ultrasound measurements of carotid, femoral and brachial arteries were performed at baseline, at 3 and 6 months after starting of treatment and the evaluation of the arterial stiffness measurements were performed by the pre-defined method.
Results
The mean age of the participants was 64.64 years. Pulsatility index, resistive index, sistolic/diastolic velocity ratio, intima-media thickness and elastic modulus values were decreased while cross-sectional compliance, cross-sectional distensibility and diastolic wall stress values were increased with treatment in carotid, femoral and brachial arteries. Carotid, femoral and brachial arteries have similar rates of change.
Conclusion
Cilostazol treatment reduced the progression of atherosclerosis without increasing the risk of bleeding in patients with peripheral arterial disease during a long-term follow-up.
Keywords
References
- Robless P, Mikhailidis DP, Stansby GP,Cilostazol for peripheral arterial disease,CD003748,2008,1
- Dormandy J, Heeck L, Vig S,The natural history of claudication: risk to life and limb,123-37,1999,12
- Peripheral Arterial Diseases Antiplatelet Consensus G.,Antiplatelet therapy in peripheral arterial disease. Consensus statement,1-16,2003,26
- Leng GC, Lee AJ, Fowkes FG, Whiteman M, Dunbar J, Housley E, et al,Incidence, natural history and cardiovascular events in symptomatic and asymptomatic peripheral arterial disease in the general population,1172-81,1996,25
- Khan S, Cleanthis M, Smout J, Flather M, Stansby G,Life-style modification in peripheral arterial disease,2-9,2005,29
- Beebe HG, Dawson DL, Cutler BS, Herd JA, Strandness DE, Bortey EB, et al.,A new pharmacological treatment for intermittent claudication: results of a randomized, multicenter trial,2041-50,1999,159
- Dawson DL, Cutler BS, Meissner MH, Strandness DE.,Cilostazol has beneficial effects in treatment of intermittent claudication: results from a multicenter, randomized, prospective, double-blind trial,678-86,1998,98
- Dawson DL, Cutler BS, Hiatt WR, Hobson RW, 2nd, Martin JD, Bortey EB, et al.,A comparison of cilostazol and pentoxifylline for treating intermittent claudication,523-30,2000;,109
- Elam MB, Heckman J, Crouse JR, Hunninghake DB, Herd JA, Davidson M, et al.,Effect of the novel antiplatelet agent cilostazol on plasma lipoproteins in patients with intermittent claudication,1942-7,1998,18
- Money SR, Herd JA, Isaacsohn JL, Davidson M, Cutler B, Heckman J, et al.,Effect of cilostazol on walking distances in patients with intermittent claudication caused by peripheral vascular disease,267-74,1998,27
- Strandness DE, Dalman RL, Panian S, Rendell MS, Comp PC, Zhang P, et al.,Effect of cilostazol in patients with intermittent claudication: a randomized, double-blind, placebo-controlled study,83-91,2002,36
- Weintraub WS.,The vascular effects of cilostazol,56B-60B,2006,22 Suppl B
- Antithrombotic Trialists C.,Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients,71-86,2002,324
- Robless P, Mikhailidis DP, Stansby G.,Systematic review of antiplatelet therapy for the prevention of myocardial infarction, stroke or vascular death in patients with peripheral vascular disease,787-800,2001,88
- Chapman TM, Goa KL.,Cilostazol: a review of its use in intermittent claudication,117-38,2003,3
- Godia EC, Madhok R, Pittman J, Trocio S, Ramas R, Cabral D, et al.,Carotid artery distensibility: a reliability study,1157-65,2007,26
- Hamilton PK, Lockhart CJ, Quinn CE, McVeigh GE.,Arterial stiffness: clinical relevance, measurement and treatment,157-70,2007,113
- Hodes RJ, Lakatta EG, McNeil CT.,Another modifiable risk factor for cardiovascular disease? Some evidence points to arterial stiffness,581-2,1995,43
- Baykara M, Ozturk C, Elbuken F.,The relationship between bone mineral density and arterial stiffness in women,441-5,2012,18
- Ahn CM, Hong SJ, Park JH, Kim JS, Lim DS.,Cilostazol reduces the progression of carotid intima-media thickness without increasing the risk of bleeding in patients with acute coronary syndrome during a 2-year follow-up,502-10,2011,26
- Liao D.,Arterial stiffness and the development of hypertension,383-5,2000,32
- Dijk JM, van der Graaf Y, Grobbee DE, Bots ML, Group SS.,Carotid stiffness indicates risk of ischemic stroke and TIA in patients with internal carotid artery stenosis: the SMART study,2258-62,2004,35
- Dijk JM, Algra A, van der Graaf Y, Grobbee DE, Bots ML, Group SS.,Carotid stiffness and the risk of new vascular events in patients with manifest cardiovascular disease. The SMART study,1213-20,2005,26
- Simons PC, Algra A, Bots ML, Grobbee DE, van der Graaf Y. :,Common carotid intima-media thickness and arterial stiffness: indicators of cardiovascular risk in high-risk patients. The SMART Study (Second Manifestations of Arterial disease).,951-7,1999,100
- Taniwaki H, Shoji T, Emoto M, Kawagishi T, Ishimura E, Inaba M, et al.,Femoral artery wall thickness and stiffness in evaluation of peripheral vascular disease in type 2 diabetes mellitus,207-14,2001,158
- Atabek ME, Kurtoglu S, Pirgon O, Baykara M.,Arterial wall thickening and stiffening in children and adolescents with type 1 diabetes.,33-40,2006,74
- van Popele NM, Grobbee DE, Bots ML, Asmar R, Topouchian J, Reneman RS, et al.,Association between arterial stiffness and atherosclerosis: the Rotterdam Study,454-60,2001,32
- Riley WA, Evans GW, Sharrett AR, Burke GL, Barnes RW.. Atherosclerosis Risk in Communities.,Variation of common carotid artery elasticity with intimal-medial thickness: the ARIC Study,57-64,1997,23
- Bild DE, Bluemke DA, Burke GL, Detrano R, Diez Roux AV, Folsom AR, et al.,Multi-Ethnic Study of Atherosclerosis: objectives and design,871-81,2002,156
- Posadzy-Malaczynska A, Kosch M, Hausberg M, Rahn KH, Stanisic G, Malaczynski P, et al.,Arterial distensibility, intima media thickness and pulse wave velocity after renal transplantation and in dialysis normotensive patients,89-94,2005,24
- Nakamura T, Houchi H, Minami A, Sakamoto S, Tsuchiya K, Niwa Y, et al.,Endothelium-dependent relaxation by cilostazol, a phosphodiesteras III inhibitor, on rat thoracic aorta,1709-15,2001,69
- Pratt CM.,Analysis of the cilostazol safety database,28D-33D,2001,28
The comparison of the effects of the cilostazol on the stiffness parameters in different arterial systems in the patients with peripheral arterial disease
Abstract
Amaç: Noninvaziv
yöntemler kullanılarak, stabil IK/PAH hastalarında silostazolünün arteriyel
uyum, distensibilite, damar sertliğini ve diğer vasküler olaylara etkisini
tespit etmek.
Gereç ve Yöntemler: Altı ay
boyunca günde iki kez 100 mg silostazol ile tedavi edilen yirmi dokuz hasta (22
erkek, 7 kadın) çalışmaya dâhil edildi. Karotid, femoral ve brakiyal arter
ultrason ölçümleri başlangıçta ve tedavi başladıktan sonra üçüncü ve altıncı ay
sonrasında yapıldı. Arteriyel sertlik ölçümlerinin değerlendirilmesi noninvaziv
yöntemlerle yapıldı. Arteriyel sertlik ölçümlerinin değerlendirilmesi önceden
tanımlanmış yöntemle gerçekleştirildi.
Bulgular: Olguların
yaş ortalaması 64 yıl idi. Karotid, femoral ve brakiyal arterde tedavi ile
kesitsel uyum, kesitsel esneklik ve diyastolik duvar gerilme değerlerinin
arttığı; pulsatilite indeksi, rezistif indeks, sistolik/diastolik hız oranı,
intima-media kalınlığı ve elastik modül değerlerinin azaldığı saptandı.
Karotis, femoral ve brakiyal arterlerdeki değişimin benzer oranları vardı.
Sonuç: Periferik
arter hastalığı olan hastalarda silostazol tedavisi uzun süreli izlemde kanama
riskini artırmadan aterosklerozun ilerlemesini azaltır.
Objective/Aim
To determine the effect of cilostazol on arterial compliance, distensibilty, vascular stiffness and other vascular events through non-invasive methods in patients with stable IC/PAD.
Method
Twenty-nine patients (22 male, 7 female) who had been treated with cilostazol 100 mg twice daily during six month were included in the study. Ultrasound measurements of carotid, femoral and brachial arteries were performed at baseline, at 3 and 6 months after starting of treatment and the evaluation of the arterial stiffness measurements were performed by the pre-defined method.
Results
The mean age of the participants was 64.64 years. Pulsatility index, resistive index, sistolic/diastolic velocity ratio, intima-media thickness and elastic modulus values were decreased while cross-sectional compliance, cross-sectional distensibility and diastolic wall stress values were increased with treatment in carotid, femoral and brachial arteries. Carotid, femoral and brachial arteries have similar rates of change.
Conclusion
Cilostazol treatment reduced the progression of atherosclerosis without increasing the risk of bleeding in patients with peripheral arterial disease during a long-term follow-up.
References
- Robless P, Mikhailidis DP, Stansby GP,Cilostazol for peripheral arterial disease,CD003748,2008,1
- Dormandy J, Heeck L, Vig S,The natural history of claudication: risk to life and limb,123-37,1999,12
- Peripheral Arterial Diseases Antiplatelet Consensus G.,Antiplatelet therapy in peripheral arterial disease. Consensus statement,1-16,2003,26
- Leng GC, Lee AJ, Fowkes FG, Whiteman M, Dunbar J, Housley E, et al,Incidence, natural history and cardiovascular events in symptomatic and asymptomatic peripheral arterial disease in the general population,1172-81,1996,25
- Khan S, Cleanthis M, Smout J, Flather M, Stansby G,Life-style modification in peripheral arterial disease,2-9,2005,29
- Beebe HG, Dawson DL, Cutler BS, Herd JA, Strandness DE, Bortey EB, et al.,A new pharmacological treatment for intermittent claudication: results of a randomized, multicenter trial,2041-50,1999,159
- Dawson DL, Cutler BS, Meissner MH, Strandness DE.,Cilostazol has beneficial effects in treatment of intermittent claudication: results from a multicenter, randomized, prospective, double-blind trial,678-86,1998,98
- Dawson DL, Cutler BS, Hiatt WR, Hobson RW, 2nd, Martin JD, Bortey EB, et al.,A comparison of cilostazol and pentoxifylline for treating intermittent claudication,523-30,2000;,109
- Elam MB, Heckman J, Crouse JR, Hunninghake DB, Herd JA, Davidson M, et al.,Effect of the novel antiplatelet agent cilostazol on plasma lipoproteins in patients with intermittent claudication,1942-7,1998,18
- Money SR, Herd JA, Isaacsohn JL, Davidson M, Cutler B, Heckman J, et al.,Effect of cilostazol on walking distances in patients with intermittent claudication caused by peripheral vascular disease,267-74,1998,27
- Strandness DE, Dalman RL, Panian S, Rendell MS, Comp PC, Zhang P, et al.,Effect of cilostazol in patients with intermittent claudication: a randomized, double-blind, placebo-controlled study,83-91,2002,36
- Weintraub WS.,The vascular effects of cilostazol,56B-60B,2006,22 Suppl B
- Antithrombotic Trialists C.,Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients,71-86,2002,324
- Robless P, Mikhailidis DP, Stansby G.,Systematic review of antiplatelet therapy for the prevention of myocardial infarction, stroke or vascular death in patients with peripheral vascular disease,787-800,2001,88
- Chapman TM, Goa KL.,Cilostazol: a review of its use in intermittent claudication,117-38,2003,3
- Godia EC, Madhok R, Pittman J, Trocio S, Ramas R, Cabral D, et al.,Carotid artery distensibility: a reliability study,1157-65,2007,26
- Hamilton PK, Lockhart CJ, Quinn CE, McVeigh GE.,Arterial stiffness: clinical relevance, measurement and treatment,157-70,2007,113
- Hodes RJ, Lakatta EG, McNeil CT.,Another modifiable risk factor for cardiovascular disease? Some evidence points to arterial stiffness,581-2,1995,43
- Baykara M, Ozturk C, Elbuken F.,The relationship between bone mineral density and arterial stiffness in women,441-5,2012,18
- Ahn CM, Hong SJ, Park JH, Kim JS, Lim DS.,Cilostazol reduces the progression of carotid intima-media thickness without increasing the risk of bleeding in patients with acute coronary syndrome during a 2-year follow-up,502-10,2011,26
- Liao D.,Arterial stiffness and the development of hypertension,383-5,2000,32
- Dijk JM, van der Graaf Y, Grobbee DE, Bots ML, Group SS.,Carotid stiffness indicates risk of ischemic stroke and TIA in patients with internal carotid artery stenosis: the SMART study,2258-62,2004,35
- Dijk JM, Algra A, van der Graaf Y, Grobbee DE, Bots ML, Group SS.,Carotid stiffness and the risk of new vascular events in patients with manifest cardiovascular disease. The SMART study,1213-20,2005,26
- Simons PC, Algra A, Bots ML, Grobbee DE, van der Graaf Y. :,Common carotid intima-media thickness and arterial stiffness: indicators of cardiovascular risk in high-risk patients. The SMART Study (Second Manifestations of Arterial disease).,951-7,1999,100
- Taniwaki H, Shoji T, Emoto M, Kawagishi T, Ishimura E, Inaba M, et al.,Femoral artery wall thickness and stiffness in evaluation of peripheral vascular disease in type 2 diabetes mellitus,207-14,2001,158
- Atabek ME, Kurtoglu S, Pirgon O, Baykara M.,Arterial wall thickening and stiffening in children and adolescents with type 1 diabetes.,33-40,2006,74
- van Popele NM, Grobbee DE, Bots ML, Asmar R, Topouchian J, Reneman RS, et al.,Association between arterial stiffness and atherosclerosis: the Rotterdam Study,454-60,2001,32
- Riley WA, Evans GW, Sharrett AR, Burke GL, Barnes RW.. Atherosclerosis Risk in Communities.,Variation of common carotid artery elasticity with intimal-medial thickness: the ARIC Study,57-64,1997,23
- Bild DE, Bluemke DA, Burke GL, Detrano R, Diez Roux AV, Folsom AR, et al.,Multi-Ethnic Study of Atherosclerosis: objectives and design,871-81,2002,156
- Posadzy-Malaczynska A, Kosch M, Hausberg M, Rahn KH, Stanisic G, Malaczynski P, et al.,Arterial distensibility, intima media thickness and pulse wave velocity after renal transplantation and in dialysis normotensive patients,89-94,2005,24
- Nakamura T, Houchi H, Minami A, Sakamoto S, Tsuchiya K, Niwa Y, et al.,Endothelium-dependent relaxation by cilostazol, a phosphodiesteras III inhibitor, on rat thoracic aorta,1709-15,2001,69
- Pratt CM.,Analysis of the cilostazol safety database,28D-33D,2001,28