Korean J Med.  2015 Sep;89(3):295-304. 10.3904/kjm.2015.89.3.295.

The Effect of Cilostazol on Arterial Stiffness in Patients Undergoing Percutaneous Coronary Intervention

• Cho SY
• Kim KH
• Ahn JH
• Kang YR
• Koh JS
• Hwang SJ
• Park Y
• Jeong YH
• Kwak CH
• Hwang JY
• Park JR

• KMID: 2269001
• DOI: http://doi.org/10.3904/kjm.2015.89.3.295

Abstract

BACKGROUND/AIMS
Increased arterial stiffness is a well-known risk factor for cardiovascular disease. Cilostazol, a phosphodiesterase type 3 inhibitor, is a unique antiplatelet agent with vasodilatory and vasoprotective effects. Therefore, we hypothesized that cilostazol may affect arterial stiffness.
METHODS
We enrolled 161 patients (112 males; mean age, 63 years) who had undergone percutaneous coronary intervention (PCI) for ischemic heart disease. The brachial-ankle pulse wave velocity (baPWV), radial augmentation index (rAI), rAI adjusted for a heart rate of 75 beats/min (rAI75), central systolic blood pressure (cSBP), and central pulse pressure (cPP), were measured at baseline and at the 30-day follow-up. Parameter changes were compared between the cilostazol group (n = 51) and the control group (n = 110).
RESULTS
In the cilostazol group, the values for rAI, cSBP, and cPP all improved after 30 days, while the control group displayed no significant interval changes in these parameters. The changes in rAI75 and baPWV did not differ significantly between the two groups. The changes in rAI, cSBP, and cPP were related to brachial systolic blood pressure, brachial diastolic blood pressure, heart rate, and the use of cilostazol and beta-blockers. In a multivariate analysis, the use of cilostazol was identified an independent factor associated with changes in rAI, cSBP, and cPP.
CONCLUSIONS
The addition of cilostazol to conventional antiplatelet therapy in patients undergoing PCI may be associated with improvements in rAI, cSBP, and cPP, but not in rAI75 or baPWV. Therefore, the effects of cilostazol might be related to an increased heart rate.

Keyword

Cilostazol; Arterial stiffness; Augmentation index

MeSH Terms

Blood Pressure
Cardiovascular Diseases
Follow-Up Studies
Heart Rate
Humans
Male
Multivariate Analysis
Myocardial Ischemia
Percutaneous Coronary Intervention*
Pulse Wave Analysis
Risk Factors
Vascular Stiffness*