Cilostazol and peripheral artery disease-specific health status in ambulatory patients with symptomatic PAD.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
01 10 2020
Historique:
received: 21 02 2020
revised: 21 04 2020
accepted: 14 05 2020
pubmed: 29 5 2020
medline: 15 5 2021
entrez: 29 5 2020
Statut: ppublish

Résumé

Improvement of symptoms and functional status is one of the main peripheral artery disease (PAD) treatment goals but pharmacological options are limited. The objective of this study was to assess the use of cilostazol and its association with patient-reported health status quantified by the Peripheral Artery Questionnaire (PAQ). Initiation of cilostazol therapy was assessed in 567 patients in the US cohort of PORTRAIT between June 2011 and December 2015. Patients with heart failure history, on cilostazol prior to enrollment, with no baseline or follow-up PAQ scores were excluded. Health status over time was quantified using linear mixed models adjusting for baseline PAQ scores and patient characteristics. Of the 567 cilostazol-naïve patients, 65 (11%) were started on cilostazol. Mean age was 68.5 ± 9.6 years, 43% were female and 71.1% white. There was no significant difference in the mean PAQ score changes from baseline to 12 months between the cilostazol and non-cilostazol group, with difference of 3.8 [CI (-2.6, 10.1), p = .24] for summary scores, 1.6 [CI (-5.5, 8.6), p = .66] for quality of life, 3.6 [CI (-4.3, 11.6), p = .37] for symptoms, 6.2 [CI (-3.1, 15.5), p = .19] for physical limitation and 3.2 [CI (-3.9, 10.2), p = .38] for social limitation scores. We found a low rate of cilostazol use and while there was no significant association between cilostazol initiation and subsequent health status, the ability to define small differences in health status was limited due to the small sample size.

Sections du résumé

BACKGROUND
Improvement of symptoms and functional status is one of the main peripheral artery disease (PAD) treatment goals but pharmacological options are limited. The objective of this study was to assess the use of cilostazol and its association with patient-reported health status quantified by the Peripheral Artery Questionnaire (PAQ).
METHODS
Initiation of cilostazol therapy was assessed in 567 patients in the US cohort of PORTRAIT between June 2011 and December 2015. Patients with heart failure history, on cilostazol prior to enrollment, with no baseline or follow-up PAQ scores were excluded. Health status over time was quantified using linear mixed models adjusting for baseline PAQ scores and patient characteristics.
RESULTS
Of the 567 cilostazol-naïve patients, 65 (11%) were started on cilostazol. Mean age was 68.5 ± 9.6 years, 43% were female and 71.1% white. There was no significant difference in the mean PAQ score changes from baseline to 12 months between the cilostazol and non-cilostazol group, with difference of 3.8 [CI (-2.6, 10.1), p = .24] for summary scores, 1.6 [CI (-5.5, 8.6), p = .66] for quality of life, 3.6 [CI (-4.3, 11.6), p = .37] for symptoms, 6.2 [CI (-3.1, 15.5), p = .19] for physical limitation and 3.2 [CI (-3.9, 10.2), p = .38] for social limitation scores.
CONCLUSIONS
We found a low rate of cilostazol use and while there was no significant association between cilostazol initiation and subsequent health status, the ability to define small differences in health status was limited due to the small sample size.

Identifiants

pubmed: 32464249
pii: S0167-5273(20)30691-4
doi: 10.1016/j.ijcard.2020.05.042
pii:
doi:

Substances chimiques

Tetrazoles 0
Cilostazol N7Z035406B

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

222-228

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Dr. Carlos Mena serves as consultant for Abbott, Boston Scientific, Cook, Medtronic, Cardinal Health. Dr. John A. Spertus owns the copyright for Peripheral Artery Questionnaire (PAQ). Dr. Kim G. Smolderen receives unrestricted grant support from Terumo, Abbott Vascular, Boston Scientific and is co-founder of Dynamo Health LLC. No other disclosures were reported.

Auteurs

Moghniuddin Mohammed (M)

Department of Medicine, Saint Luke's Hospital, Kansas City, MO, USA; University of Missouri-Kansas City, Kansas City, MO, USA.

Kensey Gosch (K)

Department of Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, MO, USA.

David Safley (D)

Department of Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, MO, USA.

Qurat-Ul-Ain Jelani (QU)

Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.

Herbert D Aronow (HD)

Cardiovascular Institute, Alpert Medical School at Brown University, Providence, RI, USA.

Carlos Mena (C)

Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.

Mehdi H Shishehbor (MH)

Division of Cardiology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

John A Spertus (JA)

Department of Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, MO, USA.

J Dawn Abbott (JD)

Cardiovascular Institute, Alpert Medical School at Brown University, Providence, RI, USA.

Kim G Smolderen (KG)

Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA. Electronic address: kim.smolderen@yale.edu.

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Classifications MeSH