Paulina Perez1, Carlos Esteban2, Joan Carles Sauquillo3, Monserrat Yeste4, Luis Manzano5, Abel Mujal6, Pedro Enrique Jiménez Caballero7, Eduardo Aguilar8, Juan Francisco Sánchez Muñoz-Torrero9, Manuel Monreal10. 1. Department of Vascular Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Facultad de Medicina, Universitat Autónoma de Barcelona, Spain. 2. Department of Vascular Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. 3. Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Spain. 4. Department of Angiology and Vascular Surgery, Hospital de Terrassa, Terrassa, Barcelona, Spain. 5. Department of Internal Medicine, Hospital Universitario Ramón y Cajal, Madrid, Spain. 6. Department of Internal Medicine, Hospital Universitari Parc Taulí Sabadell, Sabadell, Spain. 7. Department of Neurology, Hospital San Pedro de Alcántara, Cáceres, Spain. 8. Department of Internal Medicine, Hospital de Alcañiz, Alcañiz, Teruel, Spain. 9. Department of Internal Medicine, Hospital San Pedro de Alcántara, Cáceres, Spain. 10. Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. Electronic address: mmonreal.germanstrias@gencat.cat.
Abstract
BACKGROUND: Cilostazol increases the walking distance in patients with intermittent claudication, but there is scarce evidence of any effect on the risk for subsequent ischemic events, bleeding or death. PATIENTS AND METHODS: We used data from the FRENA Registry to compare the clinical outcome in stable outpatients with intermittent claudication, according to the use of cilostazol. RESULTS: As of January 2013, 1,317 patients with intermittent claudication were recruited in FRENA, of whom 191 (14.5%) received cilostazol. Over a mean follow-up of 18months, 39 patients developed myocardial infarction, 23 ischemic stroke, 20 underwent limb amputation, 15 had major bleeding and 70 died. There were no significant differences in the rate of subsequent ischemic events, major bleeding or death between patients receiving or not receiving cilostazol. On multivariate analysis, the use of cilostazol had no influence on the risk for subsequent myocardial infarction (hazard ratio [HR]: 0.97; 95% CI: 0.33-20.8), ischemic stroke (HR: 1.46; 95% CI: 0.48-4.43), limb amputation (HR: 0.34; 95% CI: 0.04-20.6), major bleeding (HR: 1.52; 95% CI: 0.33-7.09) or death (HR: 0.90; 95% CI: 0.40-20.0). CONCLUSIONS: In stable outpatients with intermittent claudication, the use of cilostazol was not associated with increased rates of subsequent ischemic events, major bleeding or death.
BACKGROUND:Cilostazol increases the walking distance in patients with intermittent claudication, but there is scarce evidence of any effect on the risk for subsequent ischemic events, bleeding or death. PATIENTS AND METHODS: We used data from the FRENA Registry to compare the clinical outcome in stable outpatients with intermittent claudication, according to the use of cilostazol. RESULTS: As of January 2013, 1,317 patients with intermittent claudication were recruited in FRENA, of whom 191 (14.5%) received cilostazol. Over a mean follow-up of 18months, 39 patients developed myocardial infarction, 23 ischemic stroke, 20 underwent limb amputation, 15 had major bleeding and 70 died. There were no significant differences in the rate of subsequent ischemic events, major bleeding or death between patients receiving or not receiving cilostazol. On multivariate analysis, the use of cilostazol had no influence on the risk for subsequent myocardial infarction (hazard ratio [HR]: 0.97; 95% CI: 0.33-20.8), ischemic stroke (HR: 1.46; 95% CI: 0.48-4.43), limb amputation (HR: 0.34; 95% CI: 0.04-20.6), major bleeding (HR: 1.52; 95% CI: 0.33-7.09) or death (HR: 0.90; 95% CI: 0.40-20.0). CONCLUSIONS: In stable outpatients with intermittent claudication, the use of cilostazol was not associated with increased rates of subsequent ischemic events, major bleeding or death.