Effects of cilostazol and pentoxifylline on forearm reactive hyperemia response, lipid profile, oxidative stress, and inflammatory markers in patients with intermittent claudication.
Peripheral arterial disease may lead to lower limb claudication and increased risk of systemic vascular dysfunction. In this article, the authors have investigated the peripheral vascular dysfunction evaluating forearm blood flow using venous occlusion plethysmography, lipid profile, and C-reactive protein in 60 patients with moderate intermittent claudication treated during 20 weeks with placebo (n = 16), cilostazol (200 mg/d; n = 17), or pentoxifylline (1200 mg/d; n = 15) in a randomized double-blinded clinical trial, taking into account smoking. Forearm blood flow after reactive hyperemia response (FBF(h) ) or oral nitroglycerine spray to evaluate endothelial-dependent and endothelial-independent vasodilation, respectively, pain-free and maximal walking distance, levels of C-reactive protein, triglycerides, cholesterol, low-density lipoprotein, and high-density lipoprotein-cholesterol in plasma were determined. The results showed that there was an improvement in the high-density lipoprotein-cholesterol, pain-free and maximal walking distance, and FBF(h) independent of treatment in nonsmoking patients. Cilostazol increased high-density lipoprotein-cholesterol level, maximal walking distance, and FBF(h), whereas pentoxifylline reduced C-reactive protein level and increased maximal walking distance in total and nonsmoking groups. No treatment was effective in smokers.
de Albuquerque
Renato Maranhão
RM
Laboratory for Research in Microcirculation, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Virgini-Magalhães
Carlos Eduardo
CE
Lencastre Sicuro
Fernando
F
Bottino
Daniel Alexandre
DA
Bouskela
Eliete
E
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood; D000077407:Cilostazol; D004311:Double-Blind Method; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced*; D007383:Intermittent Claudication / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects; D010431:Pentoxifylline / Q000627:therapeutic use*; D010991:Plethysmography; D012039:Regional Blood Flow; D012907:Smoking / Q000009:adverse effects; D013777:Tetrazoles / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*; D016138:Walking
D015415:Biomarkers; D008076:Cholesterol, HDL; D013777:Tetrazoles; D014665:Vasodilator Agents; D002097:C-Reactive Protein; D000077407:Cilostazol; D010431:Pentoxifylline