title: Treatment with cilostazol improves clinical outcome after endovascular therapy in hemodialysis patients with peripheral artery disease.
abstract: 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).
  
  
  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 100mg 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.
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: hkishii@med.nagoya-u.ac.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Cardiolovasucular Center, Nagoya Kyoritsu Hospital, Nagoya, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Aoyama
authors.affiliation: Division of Medical Statistics, Fujita Health University, Toyoake, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Surgery, Matsunami General Hospital, Kasamatsu, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kumada
authors.affiliation: Cardiolovasucular Center, Nagoya Kyoritsu Hospital, Nagoya, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kamoi
authors.affiliation: Cardiolovasucular Center, Nagoya Kyoritsu Hospital, Nagoya, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakakibara
authors.affiliation: Cardiolovasucular Center, Nagoya Kyoritsu Hospital, Nagoya, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Umemoto
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000368:Aged; D000077407:Cilostazol; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D057216:Propensity Score; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D020521:Stroke / Q000517:prevention & control; D013777:Tetrazoles / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D013777:Tetrazoles; D014665:Vasodilator Agents; D000077407:Cilostazol
keywords: Cilostazol; Hemodialysis; Peripheral artery disease; Prognosis; Stroke