Effects of cilostazol against the progression of carotid IMT in symptomatic ischemic stroke patients

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• 作者：Sung Hyuk Heo (1)
  Ji Sung Lee (2)
  Beom Joon Kim (3)
  Kyoung Jin Hwang (1)
  Jun-Hyun Kim (1)
  Dae-Il Chang (1)
  
• 关键词：Stroke ; Carotid intima ; media thickness ; Atherosclerosis ; Cilostazol
• 刊名：Journal of Neurology
• 出版年：2013
• 出版时间：January 2013
• 年：2013
• 卷：260
• 期：1
• 页码：122-130
• 全文大小：266KB
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• 作者单位：Sung Hyuk Heo (1)
  Ji Sung Lee (2)
  Beom Joon Kim (3)
  Kyoung Jin Hwang (1)
  Jun-Hyun Kim (1)
  Dae-Il Chang (1)
  
  1. Department of Neurology, Kyung Hee University Hospital, #1, Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea
  2. Department of Biostatistics, Korea University, Seoul, Korea
  3. Department of Neurology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea
  
• ISSN：1432-1459

文摘

Carotid intima-media thickness (IMT) is a surrogate marker for evaluating atherosclerotic vascular diseases. The phosphodiesterase inhibitor cilostazol attenuates the increase in carotid IMT in diabetes patients. We studied whether cilostazol can reduce the progression of carotid IMT in symptomatic ischemic stroke patients. From our prospective registry of acute ischemic stroke patients who were admitted during a 4.5-year period, follow-up carotid ultrasound was performed in a random sample of survivors. Patients were divided into two groups: the cilostazol group, who continued cilostazol treatment during the follow-up period; and the control group, who were prescribed antiplatelets other than cilostazol. Analysis of covariance and propensity score-matched analysis were used to evaluate the difference between groups. Among a total of 1,049 cases in our registry, 208 patients were utilized to construct two comparable sets by propensity score analysis, including 101 who received cilostazol and 107 who took antiplatelet medication without cilostazol. Both maximum and mean carotid IMT values were significantly reduced in the cilostazol group but increased in the control group (maximum left -.048?±?0.186 vs. 0.022?±?0.163?mm, p?=?0.001; maximum right -.037?±?0.173 vs. 0.050?±?0.200?mm, p?=?0.001; mean left -.052?±?0.102 vs. 0.023?±?0.112?mm, p?<?0.001; and mean right -.038?±?0.106 vs. 0.042?±?0.139?mm, p?<?0.001). After matching by propensity score, the improvements in both maximum and mean carotid IMT values in the cilostazol group remained significant. This study shows that cilostazol causes a significant regression in carotid IMT in symptomatic stroke patients.