THE EFFECTIVENESS OF CILOSTAZOL IN PATIENTS WITH GENERALIZED ATHEROSCLEROSIS

Tetiana Motsak; Lizogub V. G.; Kupchynska O. G.; Bugaytsev O. O.

doi:10.31435/rsglobal_ws/30062020/7108

Tetiana Motsak PhD student, an assistant of Department of Internal Medicine No4, Bogomolets National Medical University, Kyiv, Ukraine https://orcid.org/0000-0002-5545-8583
Lizogub V. G. Doctor of Medical Science, Professor, Head of Department of Internal Medicine No4, Bogomolets National Medical University, Kyiv, Ukraine https://orcid.org/0000-0003-3603-7342
Kupchynska O. G. Doctor of Medical Science, Professor, Bogomolets National Medical University, SI «National Scientific Center «M.D. Strazhesko Institute of Cardiology, Kyiv; Ukraine https://orcid.org/0000-0002-5615-192X
Bugaytsev O. O. Candidate of Medical Science, Bogomolets National Medical University, Kyiv, Ukraine https://orcid.org/0000-0002-3513-6712

DOI: https://doi.org/10.31435/rsglobal_ws/30062020/7108

Keywords: generalized atherosclerosis, blood flow rate, myocardial ischemia, cognitive function, cilostazol

Abstract

The aim of the study is to investigate the effectiveness of cilostazol in patients with generalized atherosclerosis (GAS).
A comprehensive examination of 65 male patients with proved GAS was performed (lesions of the lower extremities, carotid, mesenteric, coronary, cerebral arteries) and 28 healthy males (comparison group - CG) aged over 60 years. Patients with GAS consisted of 2 groups: GAS1 - patients in addition to basic therapy received cilostazol (C; 100 mg 2 times per day); GAS2 - placebo. Patients with GAS showed a significant deterioration in blood flow (decrease in its volumetric blood flow - FV, increase in peak systolic velocity - PSV) in all studied arteries, episodes of myocardial ischemia according to daily ECG monitoring, decreased cognitive function (CF). In patients with GAS1 on the background of taking C observed improvement (p<0,001) blood flow in the studied arteries (increase in FV and decrease in PSV), decrease in the number and duration of episodes of myocardial ischemia (p<0,01 and p<0,05, respectively), increase distances of painless and maximum walking distance (p<0,01), improvement of CF. The data obtained indicate the effectiveness of C as part of complex therapy in patients with GAS and expediency of further research in this direction to clarify the criteria for its appointment to such patients.

References

Vinogradova Yu.A. Intermittent claudication: from history to the present. RMR - 2019, №8 (11) - P.90-93 [in Russian]

Lizogub V.G., Kupchinska E.G., Bugaytsev A.A. Cilostazol – antiplatelet drug with great prospects Medicine of Ukraine2018 - №2 (218). -p.10-15.[in Russian]

Farkas Katalin, Járai Zoltán, Kolossváry Endre. Cilostazol Is Effective and Safe Option for the Treatment of Intermittent Claudication. Results of the NOCLAUD Study Orv Hetil. 2017 Jan;158(4):123-128. doi: 10.1556/650.2017.30660.

FowkesFG, MurrayGD, ButcherI, HealdCL, LeeRJ, ChamblessLE, et al. Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis. JAMA 2008; 300:197– 208

Friedland S.N., Eisenberg M.J., Shimony A. Meta-analysis of randomized contolled trrails on effect of cilostazol on restenosis rates and outcomes after percutaneous coronary intervention // Am. J. Cardiol. – 2012. – Vol.109 (10). – P.1397-1404

Helmy Moawad, Sally A El Awdan, Nada A Sallam, Wafaa I El-Eraky, Mohammed A Alkhawlani. Gastroprotective Effect of Cilostazol Against Ethanol- And Pylorus Ligation-Induced Gastric Lesions in Rats. NaunynSchmiedebergs Arch Pharmacol. 2019 Dec;392(12):1605-1616. doi: 10.1007/s00210-019-01699-y. Epub 2019 Aug 1.

Khoury Z., Schwartz R., Gottlieb S et al. Relation of coronary artery disease to atherosclerotic disease in the aorta, carotid, and femoral arteries evaluated by ultrasound. Am J Cardiol. – 1997; 80: 1429-1433

8. Lambert M. A., Belch J. J. F. Medical management of critical limb ischaemia: where do we stand today? Journal of Internal Medicine. – 2013. – Vol. 274. – P. 295–307.doi: 10.1111/joim.12102 https://angiology.com.ua/ru-issue-article-569

Mozaffarian D., Benjamin E., Go A. et al. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation 2016; 133: e38-360

Roset PN. Systematic review of the efficacy of cilostazol, naftidrofuryl oxalate and pentoxifylline for the treatment of intermittent claudication (Br J Surg 2012; 99: 1630-1638). Br J Surg, 2013 Dec, 100(13): 1838. doi: 10.1002/bjs.9357.

Shin E.S., Lee J.H., Yoo S.Y. et al. A randomized, multicentre double-blind, placebo controlled trial to evaluate the efficacy and safety of cilostazol in patients woth vasospastic angina // Heart doi:10, 1136/heartjnl-2014-305986

Sung Hyuk Heo, Ji Sung Lee, Beom Joon Kim et al. Effects of cilostazol against the progression of carotid AMT in symptomatic ischemic stroke patients // J. Neurol. – 2013. – Vol.260, N1. – P.122-130

Townsend N., Nichols M., Scarborough P. et al. Cardiovascular disease in Europe – epidemiological update 2015. EurHeart J 2015; 36; 2696-705

Uchiyama S., Shinohara Y., Katahashi Y. et al. Benefit of Cilostazol in Patients with High Risk of Bleeding: Subanalysis of Cilostazol Stroke Prevention Study 2 // Cerebrovasc Dis. – 2014. – Vol.37. – P.296-303

2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS) // European Heart Journal, Volume 39, Issue 9, 01 March 2018, Pages 763–816 https://academic.oup.com/eurheartj/article/39/9/763/4095038