title: Role of Cilostazol Therapy in Hemodialysis Patients with Asymptomatic Peripheral Arterial Disease: A Retrospective Cohort Study.
abstract: Background. Peripheral arterial disease (PAD) and its relevant complications are more common in hemodialysis (HD) patients, while the evidence regarding antiplatelet therapy in CKD patients is scarce. We retrospectively analyzed the efficacy of cilostazol on outcomes in HD patients with asymptomatic PAD (aPAD).Methods. This cohort study enrolled 217 HD patients (median follow-up time: 5.75 years). Associations between cilostazol use and the outcomes were evaluated by time-dependent Cox regression analysis.Results. During follow-up, 39.5% (47/119) patients used cilostazol for aPAD and 31.8% (69/217) patients died. Cilostazol users had significantly lower CVD and all-cause mortalities (adjusted HR [95% CI]: 0.11 [0.03, 0.51] and 0.2 [0.08, 0.52]) than nonusers. Both death risks were nonsignificantly higher in cilostazol users than in HD patients without aPAD. The unadjusted and adjusted HR [95% CI] of CVD death risk were 0.4 [0.07, 2.12] and 0.14 [0.02, 0.8] for patients with aPAD during follow-up and were 0.74 [0.16, 3.36] and 0.19 [0.04, 0.93] for those with aPAD at initial.Conclusions. In HD patients with aPAD, lower CVD and all-cause mortality rates were observed in low-dose cilostazol user. Further evidences from large-scale prospective study and randomization trial are desired to confirm the effect of cilostazol.
authors.affiliation: Division of Renal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan; Department of Internal Medicine, Taipei Medical University, Taipei, Taiwan; Department of Rehabilitation, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
authors.forename: Paik Seong
authors.identifier: 0000-0003-3888-9004
authors.initials: PS
authors.lastname: Lim
authors.affiliation: Department of Rehabilitation, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan; Division of Biostatistics and Epidemiology, Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.
authors.forename: Yachung
authors.identifier: 0000-0002-0860-3784
authors.initials: Y
authors.lastname: Jeng
authors.affiliation: Division of Renal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.
authors.forename: Ming Ying
authors.initials: MY
authors.lastname: Wu
authors.affiliation: Division of Renal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.
authors.forename: Mei-Ann
authors.initials: MA
authors.lastname: Pai
authors.affiliation: Division of Renal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.
authors.forename: Tsai-Kun
authors.initials: TK
authors.lastname: Wu
authors.affiliation: Division of Renal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.
authors.forename: Chang Hsu
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D000077407:Cilostazol; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D012044:Regression Analysis; D006435:Renal Dialysis; D012189:Retrospective Studies; D012306:Risk; D020521:Stroke / Q000150:complications / Q000517:prevention & control; D013777:Tetrazoles / Q000627:therapeutic use*
chemical_list: D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077407:Cilostazol