TY - JOUR
T1 - Treatment with cilostazol improves clinical outcome after endovascular therapy in hemodialysis patients with peripheral artery disease
AU - Ishii, Hideki
AU - Aoyama, Toru
AU - Takahashi, Hiroshi
AU - Kumada, Yoshitaka
AU - Kamoi, Daisuke
AU - Sakakibara, Takashi
AU - Umemoto, Norio
AU - Suzuki, Susumu
AU - Tanaka, Akihito
AU - Ito, Yasuhiko
AU - Murohara, Toyoaki
N1 - Funding Information:
H.I. received lecture fees from Astellas Pharma Inc., Daiichi Sankyo Co., Ltd., and Otsuka Pharma Inc. Y.I. received lecture fees from Baxter Co., Ltd., Chugai Pharma Inc., Daiichi Sankyo Co., Ltd., JMS Co., Ltd., Kyowa Hakko Kirin Co., Ltd, MSD K.K., Takeda Pharmaceutical Co., Ltd., and Terumo Co., Ltd. T.M. received lecture fees from Bayel Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K.K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K.K., Pfizer Japan Inc., Sanofi-Aventis K.K., and Takeda Pharmaceutical Co., Ltd. Y.I. received unrestricted research grant from Daiichi Sankyo Co., Ltd., Kyowa Hakko Kirin Co., Ltd, and MSD K.K. T.M. received unrestricted research grant for Department of Cardiology, Nagoya University Graduate School of Medicine from Astellas Pharma Inc, Daiichi Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K.K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K.K., Otsuka Pharma Ltd., Pfizer Japan Inc., Sanofi-Aventis K.K., Takeda Pharmaceutical Co., Ltd., and Teijin Pharma Ltd. Department of Renal Replacement therapy is endowed by Baxter Co., Ltd.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - 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 100. mg 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.
AB - 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 100. mg 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.
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U2 - 10.1016/j.jjcc.2015.05.003
DO - 10.1016/j.jjcc.2015.05.003
M3 - Article
C2 - 26074442
AN - SCOPUS:84955410783
VL - 67
SP - 199
EP - 204
JO - Journal of Cardiology
JF - Journal of Cardiology
SN - 0914-5087
IS - 2
ER -