Cilostazol and peripheral artery disease-specific health status in ambulatory patients with symptomatic PAD. (1st October 2020)

• Record Type: Journal Article
• Authors: Mohammed, Moghniuddin; Gosch, Kensey; Safley, David; Jelani, Qurat-Ul-Ain; Aronow, Herbert D.; Mena, Carlos; Shishehbor, Mehdi H.; Spertus, John A.; Abbott, J. Dawn; Smolderen, Kim G.
• Is Part Of: International journal of cardiology. Volume 316(2020)
• Page Start: 222
• Page End: 228
• Publication Date: 2020-10-01
• Subjects: Cilostazol -- Quality of life -- Peripheral artery disease -- Outcomes -- Intermittent claudication; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2020.05.042
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Improvement of symptoms and functional status is one of the main peripheral artery disease (PAD) treatment goals but pharmacological options are limited. The objective of this study was to assess the use of cilostazol and its association with patient-reported health status quantified by the Peripheral Artery Questionnaire (PAQ). Methods: Initiation of cilostazol therapy was assessed in 567 patients in the US cohort of PORTRAIT between June 2011 and December 2015. Patients with heart failure history, on cilostazol prior to enrollment, with no baseline or follow-up PAQ scores were excluded. Health status over time was quantified using linear mixed models adjusting for baseline PAQ scores and patient characteristics. Results: Of the 567 cilostazol-naïve patients, 65 (11%) were started on cilostazol. Mean age was 68.5 ± 9.6 years, 43% were female and 71.1% white. There was no significant difference in the mean PAQ score changes from baseline to 12 months between the cilostazol and non-cilostazol group, with difference of 3.8 [CI (−2.6, 10.1), p = .24] for summary scores, 1.6 [CI (−5.5, 8.6), p = .66] for quality of life, 3.6 [CI (−4.3, 11.6), p = .37] for symptoms, 6.2 [CI (−3.1, 15.5), p = .19] for physical limitation and 3.2 [CI (−3.9, 10.2), p = .38] for social limitation scores. Conclusions: We found a low rate of cilostazol use and while there was no significant association between cilostazol initiation and subsequent health status, the ability to define small differences in health status was limited due to the small sample size. Highlights: One of the main peripheral artery disease treatment goal is to improve symptoms. Cilostazol is the only FDA approved medicine recommended by guidelines. Limited data on patient reported outcomes and Cilostazol use beyond 6 months. Assess patient reported outcomes in Cilostazol vs non-Cilostazol group at 1 year. We found no significant difference between 2 groups using real world data.