Background: Cilosazol has been known to have an anti-atherosclerotic effects as well as anti-platelet effects. We sought to evaluate the effects of Cilostazol on carotid atherosclerosis in patients with early coronary atherosclerosis.
Methods: Study subjects consisted of 176 consecutive patients with angiographically proven early coronary atherosclerosis (stenosed 30% to 70%). Carotid intima-media thickness (CIMT) was measured by high-resolution ultrasound and semi-automatic method. The study subjects were divided into two groups and followed up for mean 10.4±6.9months; Cilostazol group (n=63, mean 59.0±9.0 years old, 23 males (36.5%)) who had Cilostazol 100mg twice/day with conventional medication for underlying disease, control group (mean 59.7±9.8 years old, 46 males (40.7%)) who had conventional medication only.
Results: There was no significant difference between Cilostazol and control groups in terms of clinical variables, medications during follow up period, and baseline CIMT (Right CIMT; 0.791±0.150mm vs. 0.780±0.141mm, Left CIMT; 0.791±0.153mm vs. 0.785±0.150mm, respectively). Cilostazol group showed significant reduction of right CIMT (n=57, from 0.794±0.152mm to 0.769±0.127mm, p=0.004) and tendency to decreased left CIMT (n=57, from 0.792±0.157mm to 0.780±0.155, p=0.054), whereas control group showed no significant changes of right and left CIMT. In terms of carotid plaque, there was no significant difference of prevalence (25.4% vs. 15.9%, p=0.127) between Cilostazol and control group, respectively, although the plaque thickness of Cilostazol group was higher (2.468±0.592mm vs. 2.096±0.408mm, p=0.039) than control group. The plaque thickness of Cilostazol group showed no significant changes, whereas the plaque thickness of control group was increased from 2.102±0.420mm to 2.221±0.460mm (p=0.015, n=17).
Conclusion: Cilostazol could regress CIMT in patients with early coronary atherosclerosis and prevent carotid plaque progression. This study suggests that Cilostazol has beneficial effects on carotid atherosclerosis, which is a predictor for future cardiovascular events, in patients with early coronary atherosclerosis.
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