Long-Term Effectiveness of Cilostazol in Patients with Hemodialysis with Peripheral Artery Disease

Abstract

The aim of this study was to investigate the effects of continuous cilostazol use on emergency department (ED) visits, hospitalizations, and vascular outcomes in patients with hemodialysis (HD) with peripheral artery disease (PAD).Methods: This retrospective cohort study recruited 558 adult patients, who had received chronic HD for at least 90 days between January 1, 2008 and December 31, 2012, from the National Health Insurance Research Database. Eligible patients were divided into two groups based on continuing or discontinuing cilostazol treatment. Outcome measures were ED visits, hospitalizations, mortality, and vascular outcomes such as percutaneous transluminal angioplasty, surgical bypass, lower leg amputation, ischemic stroke, hemorrhagic stroke, and cardiovascular events.Results: Patients with continuous cilostazol use had significantly higher prevalence of stroke, cancer, vintage, and the use of angiotensin receptor blocker and β-blocker, but significantly lower incidence of ischemic stroke and cardiovascular events, as well as lower mortality, than those without continuous cilostazol use (all p＜.05). Continuous cilostazol use was independently associated with lower risk of ED visits, hemorrhagic stroke, and cardiovascular events (adjusted hazard ratios: 0.79, 0.29, and 0.67; 95% confidence intervals: 0.62-0.98, 0.10-0.84, and 0.48-0.96, respectively; all p＜.05). Continuous cilostazol use was significantly associated with higher ED visit-free and cardiovascular event-free rates (log-rank test; p＜.05). Conclusion:Continuous treatment of cilostazol in patients with HD with PAD significantly decreases the risk of ED visits, hemorrhagic stroke, and cardiovascular events and improves ED visit-free and cardiovascular eventfree rates during long-term follow-up.

Association of Smoking, Diabetes, and Dialysis with the Presence of Popliteal Lesions in Femoropopliteal Artery Disease

“…Respective cardiovascular risk factors per se might be complexly linked with one another 26) . Second, details of cardiovascular risk factors [27][28][29][30] , medications [31][32][33][34] , and other general conditions 35,36) were not analyzed in this study. Third, our study population was limited to patients undergoing femoropopliteal DCB treatment, which would cause a selection bias.…”

Analyzing the Effects of Statin on Long Term Mortality in Coronary Artery Disease

“…Statins are widely utilised in the primary and secondary prevention of cardiovascular disease caused by atherosclerosis [11]. They are advised for people with high levels of LDL cholesterol, for those who have diabetes or high blood pressure, who are at higher risk of cardiovascular disease, and for people who have previously had a cardiovascular event [12].…”