The vascular and biochemical effects of cilostazol in diabetic patients with peripheral arterial disease.
OBJECTIVE
Cilostazol improves walking in patients with peripheral arterial disease (PAD). We hypothesized that cilostazol reduces diabetic complications in PAD patients.


METHODS
Diabetic PAD patients were prospectively recruited to a randomized double-blinded, placebo-controlled trial, using cilostazol 100mg twice a day. Clinical assessment included ankle-brachial index, arterial compliance, peripheral transcutaneous oxygenation, treadmill walking distance and validated quality of life (QoL) questionnaires. Biochemical analyses included glucose and lipid profiles. All tests were at baseline, 6, and 24 weeks.


RESULTS
26 diabetic PAD patients (20 men) were recruited. Cilostazol improved absolute walking distance at 6 and 24 weeks (86.4% vs. 14.1%, P = .049; 143% vs. 23.2%, P = .086). Arterial compliance and lipid profiles improved as did some QoL indices for cilostazol at 6 and 24 weeks. Blood indices were similar at baseline and at follow-up points for both treatment groups.


CONCLUSIONS
Cilostazol is a well-tolerated and efficacious treatment, which improves claudication distances in diabetic PAD patients with further benefits in arterial compliance, lipid profiles, and QoL.
O'Donnell
Mark E
ME
Department of Vascular and Endovascular Surgery, Belfast City Hospital, Northern Ireland, United Kingdom. modonnell904@hotmail.com
Badger
Stephen A
SA
Sharif
Muhammad A
MA
Makar
Ragai R
RR
Young
Ian S
IS
Lee
Bernard
B
Soong
C V
CV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000098:blood supply; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000077407:Cilostazol; D003187:Compliance; D003925:Diabetic Angiopathies / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007383:Intermittent Claudication / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013777:Tetrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking
D015415:Biomarkers; D001786:Blood Glucose; D002317:Cardiovascular Agents; D000077407:Cilostazol; D006442:Glycated Hemoglobin; D007328:Insulin; D008055:Lipids; D010100:Oxygen; D013777:Tetrazoles; C517652:hemoglobin A1c protein, human