Effect of cilostazol oncarotid intima media thickness in type 2 diabetic patients without cardiovascular event

Abstract

ObjectivesWe investigated the efficacy of cilostazol treatment for 2 years on theattenuation of carotid intima media thickness (IMT) progression in type 2diabetic patients without cardiovascular disease history, as comparedwith other antiplatelet agents.MethodsWe recruited a total of 230 type 2 diabetic patients who had undergoneIMT measurement twice within a 1.5–2.5 year (mean 2.06 ± 0.32 years)interval. Among these participants, we classified them into three groupsaccording to antiplatelet agent administration at baseline: Group I (n =66), antiplatelet naïve; Group II (n= 75), other antiplatelet agentadministration; Group III (n = 50), cilostazol administration. We thenanalyzed the changes in clinical characteristics from baseline to 2 years.ResultsThe changes in annual mean IMT at2 years were 0.019 ± 0.045 mm/year,–0.001 ± 0.058 mm/year and –0.019 ± 0.043 mm/year for Group I, II andIII, respectively (P < 0.001). Mean change in total cholesterol, lowdensity lipoprotein (LDL)-cholesterol and triglyceride compared withbaseline decreased the most in Group III even after adjustment for statinuse. We also observed that the odds ratio of carotid IMT progression at 2years was lowest in patients who were treated with cilostazol even afteradjustment for change of metabolicparameters. When we categorizedpatients according to baseline carotidIMT tertile, the efficacy ofcilostazol against carotid IMT progression was significant only whenbaseline IMT was over 0.662 mm (mean : 0.801).ConclusionsTwo-year treatment with cilostazol strongly inhibited carotid IMTprogression compared to other antiplatelet agents in type 2 diabeticpatients. This beneficial effect of cilostazol was significant when baselineIMT was thicker than 0.662 mm (mean 0.801 mm).