Cilostazol improves long-term patency after percutaneous transluminal angioplasty in hemodialysis patients with peripheral artery disease

Hideki Ishii, Yoshitake Kumada, Takanobu Toriyama, Toru Aoyama, Hiroshi Takahashi, Shigeki Yamada, Yoshinari Yasuda, Yukio Yuzawa, Shoichi Maruyama, Seiichi Matsuo, Tatsuaki Matsubara, Toyoaki Murohara

Research output: Contribution to journalArticle

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Abstract

Background and objectives: Peripheral artery disease (PAD) is common in patients on hemodialysis (HD). Recently, cilostazol has been reported to reduce target lesion revascularization (TLR) after percutaneous transluminal angioplasty (PTA) for PAD in the general population. This study aimed to clarify the effects of cilostazol administration on long-term patency after PTA in HD patients. Design, setting, participants, & measurements: Three-hundred seventy-two consecutive lesions in 193 HD patients successfully undergoing PTA were enrolled in the study and divided into two groups: patients receiving 100 mg cilostazol twice daily in conjunction with standard therapy (130 lesions in 71 patients) and those not administered cilostazol (242 lesions in 122 patients). Effects of cilostazol on preventing restenosis after PTA in these patients were investigated. Results: Kaplan-Meier analysis demonstrated the 5-yr patency rate was significantly higher in the cilostazol group than in the control group [52.4 versus 32.9%, hazard ratio (HR) 0.55; 95% confidence interval (CI) 0.39 to 0.77, P = 0.0005]. Cox multivariate analysis revealed that administration of cilostazol was an independent predictor of preventing restenosis (HR 0.56, 95% Cl 0.36 to 0.87, P = 0.010). In 102 lesions matched after propensity score analysis, cilostazol had a beneficial effect on preventing restenosis (58.4 versus 34.7%, HR 0.47, 95% Cl 0.30 to 0.75, P = 0.0017) and was an independent predictor of preventing restenosis (HR 0.50; 95% Cl 0.26 to 0.87, P = 0.014) after multivariate Cox analysis. Conclusions: Cilostazol administration improves long-term patency after PTA in HD patients with PAD.

Original languageEnglish
Pages (from-to)1034-1040
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume3
Issue number4
DOIs
Publication statusPublished - 01-07-2008
Externally publishedYes

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Peripheral Arterial Disease
Angioplasty
Renal Dialysis
Multivariate Analysis
cilostazol
Propensity Score
Kaplan-Meier Estimate
Confidence Intervals
Control Groups

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Ishii, Hideki ; Kumada, Yoshitake ; Toriyama, Takanobu ; Aoyama, Toru ; Takahashi, Hiroshi ; Yamada, Shigeki ; Yasuda, Yoshinari ; Yuzawa, Yukio ; Maruyama, Shoichi ; Matsuo, Seiichi ; Matsubara, Tatsuaki ; Murohara, Toyoaki. / Cilostazol improves long-term patency after percutaneous transluminal angioplasty in hemodialysis patients with peripheral artery disease. In: Clinical Journal of the American Society of Nephrology. 2008 ; Vol. 3, No. 4. pp. 1034-1040.
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title = "Cilostazol improves long-term patency after percutaneous transluminal angioplasty in hemodialysis patients with peripheral artery disease",
abstract = "Background and objectives: Peripheral artery disease (PAD) is common in patients on hemodialysis (HD). Recently, cilostazol has been reported to reduce target lesion revascularization (TLR) after percutaneous transluminal angioplasty (PTA) for PAD in the general population. This study aimed to clarify the effects of cilostazol administration on long-term patency after PTA in HD patients. Design, setting, participants, & measurements: Three-hundred seventy-two consecutive lesions in 193 HD patients successfully undergoing PTA were enrolled in the study and divided into two groups: patients receiving 100 mg cilostazol twice daily in conjunction with standard therapy (130 lesions in 71 patients) and those not administered cilostazol (242 lesions in 122 patients). Effects of cilostazol on preventing restenosis after PTA in these patients were investigated. Results: Kaplan-Meier analysis demonstrated the 5-yr patency rate was significantly higher in the cilostazol group than in the control group [52.4 versus 32.9{\%}, hazard ratio (HR) 0.55; 95{\%} confidence interval (CI) 0.39 to 0.77, P = 0.0005]. Cox multivariate analysis revealed that administration of cilostazol was an independent predictor of preventing restenosis (HR 0.56, 95{\%} Cl 0.36 to 0.87, P = 0.010). In 102 lesions matched after propensity score analysis, cilostazol had a beneficial effect on preventing restenosis (58.4 versus 34.7{\%}, HR 0.47, 95{\%} Cl 0.30 to 0.75, P = 0.0017) and was an independent predictor of preventing restenosis (HR 0.50; 95{\%} Cl 0.26 to 0.87, P = 0.014) after multivariate Cox analysis. Conclusions: Cilostazol administration improves long-term patency after PTA in HD patients with PAD.",
author = "Hideki Ishii and Yoshitake Kumada and Takanobu Toriyama and Toru Aoyama and Hiroshi Takahashi and Shigeki Yamada and Yoshinari Yasuda and Yukio Yuzawa and Shoichi Maruyama and Seiichi Matsuo and Tatsuaki Matsubara and Toyoaki Murohara",
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Ishii, H, Kumada, Y, Toriyama, T, Aoyama, T, Takahashi, H, Yamada, S, Yasuda, Y, Yuzawa, Y, Maruyama, S, Matsuo, S, Matsubara, T & Murohara, T 2008, 'Cilostazol improves long-term patency after percutaneous transluminal angioplasty in hemodialysis patients with peripheral artery disease', Clinical Journal of the American Society of Nephrology, vol. 3, no. 4, pp. 1034-1040. https://doi.org/10.2215/CJN.05761207

Cilostazol improves long-term patency after percutaneous transluminal angioplasty in hemodialysis patients with peripheral artery disease. / Ishii, Hideki; Kumada, Yoshitake; Toriyama, Takanobu; Aoyama, Toru; Takahashi, Hiroshi; Yamada, Shigeki; Yasuda, Yoshinari; Yuzawa, Yukio; Maruyama, Shoichi; Matsuo, Seiichi; Matsubara, Tatsuaki; Murohara, Toyoaki.

In: Clinical Journal of the American Society of Nephrology, Vol. 3, No. 4, 01.07.2008, p. 1034-1040.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cilostazol improves long-term patency after percutaneous transluminal angioplasty in hemodialysis patients with peripheral artery disease

AU - Ishii, Hideki

AU - Kumada, Yoshitake

AU - Toriyama, Takanobu

AU - Aoyama, Toru

AU - Takahashi, Hiroshi

AU - Yamada, Shigeki

AU - Yasuda, Yoshinari

AU - Yuzawa, Yukio

AU - Maruyama, Shoichi

AU - Matsuo, Seiichi

AU - Matsubara, Tatsuaki

AU - Murohara, Toyoaki

PY - 2008/7/1

Y1 - 2008/7/1

N2 - Background and objectives: Peripheral artery disease (PAD) is common in patients on hemodialysis (HD). Recently, cilostazol has been reported to reduce target lesion revascularization (TLR) after percutaneous transluminal angioplasty (PTA) for PAD in the general population. This study aimed to clarify the effects of cilostazol administration on long-term patency after PTA in HD patients. Design, setting, participants, & measurements: Three-hundred seventy-two consecutive lesions in 193 HD patients successfully undergoing PTA were enrolled in the study and divided into two groups: patients receiving 100 mg cilostazol twice daily in conjunction with standard therapy (130 lesions in 71 patients) and those not administered cilostazol (242 lesions in 122 patients). Effects of cilostazol on preventing restenosis after PTA in these patients were investigated. Results: Kaplan-Meier analysis demonstrated the 5-yr patency rate was significantly higher in the cilostazol group than in the control group [52.4 versus 32.9%, hazard ratio (HR) 0.55; 95% confidence interval (CI) 0.39 to 0.77, P = 0.0005]. Cox multivariate analysis revealed that administration of cilostazol was an independent predictor of preventing restenosis (HR 0.56, 95% Cl 0.36 to 0.87, P = 0.010). In 102 lesions matched after propensity score analysis, cilostazol had a beneficial effect on preventing restenosis (58.4 versus 34.7%, HR 0.47, 95% Cl 0.30 to 0.75, P = 0.0017) and was an independent predictor of preventing restenosis (HR 0.50; 95% Cl 0.26 to 0.87, P = 0.014) after multivariate Cox analysis. Conclusions: Cilostazol administration improves long-term patency after PTA in HD patients with PAD.

AB - Background and objectives: Peripheral artery disease (PAD) is common in patients on hemodialysis (HD). Recently, cilostazol has been reported to reduce target lesion revascularization (TLR) after percutaneous transluminal angioplasty (PTA) for PAD in the general population. This study aimed to clarify the effects of cilostazol administration on long-term patency after PTA in HD patients. Design, setting, participants, & measurements: Three-hundred seventy-two consecutive lesions in 193 HD patients successfully undergoing PTA were enrolled in the study and divided into two groups: patients receiving 100 mg cilostazol twice daily in conjunction with standard therapy (130 lesions in 71 patients) and those not administered cilostazol (242 lesions in 122 patients). Effects of cilostazol on preventing restenosis after PTA in these patients were investigated. Results: Kaplan-Meier analysis demonstrated the 5-yr patency rate was significantly higher in the cilostazol group than in the control group [52.4 versus 32.9%, hazard ratio (HR) 0.55; 95% confidence interval (CI) 0.39 to 0.77, P = 0.0005]. Cox multivariate analysis revealed that administration of cilostazol was an independent predictor of preventing restenosis (HR 0.56, 95% Cl 0.36 to 0.87, P = 0.010). In 102 lesions matched after propensity score analysis, cilostazol had a beneficial effect on preventing restenosis (58.4 versus 34.7%, HR 0.47, 95% Cl 0.30 to 0.75, P = 0.0017) and was an independent predictor of preventing restenosis (HR 0.50; 95% Cl 0.26 to 0.87, P = 0.014) after multivariate Cox analysis. Conclusions: Cilostazol administration improves long-term patency after PTA in HD patients with PAD.

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