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Vascular and Endovascular Surgery
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The Vascular and Biochemical Effects of Cilostazol in Diabetic Patients With Peripheral Arterial Disease

Mark E. O'Donnell, DSEM, MD, MFSEM, MRCS

Department of Vascular and Endovascular Surgery, Belfast City Hospital, Northern Ireland, United Kingdom, modonnell904{at}hotmail.com

Stephen A. Badger, MD, MRCS

Department of Vascular and Endovascular Surgery, Belfast City Hospital, Northern Ireland, United Kingdom

Muhammad A. Sharif, MS, MD, FRCS

Department of Vascular and Endovascular Surgery, Belfast City Hospital, Northern Ireland, United Kingdom

Ragai R. Makar, MS, FRCS

Department of Vascular and Endovascular Surgery, Belfast City Hospital, Northern Ireland, United Kingdom

Ian S. Young, MD, FRCP, FRCPath

Department of Medicine, Queen's University Belfast, Northern Ireland, United Kingdom

Bernard Lee, FRCS

Department of Vascular and Endovascular Surgery, Belfast City Hospital, Northern Ireland, United Kingdom

C.V. Soong, MD, FRCS

Department of Vascular and Endovascular Surgery, Belfast City Hospital, Northern Ireland, United Kingdom

Objectives: Cilostazol improves walking in patients with peripheral arterial disease (PAD). We hypothesized that cilostazol reduces diabetic complications in PAD patients.

Methods: Diabetic PAD patients were prospectively recruited to a randomized double-blinded, placebo-controlled trial, using cilostazol 100mg twice a day. Clinical assessment included ankle-brachial index, arterial compliance, peripheral transcutaneous oxygenation, treadmill walking distance and validated quality of life (QoL) questionnaires. Biochemical analyses included glucose and lipid profiles. All tests were at baseline, 6, and 24 weeks.

Results: 26 diabetic PAD patients (20 men) were recruited. Cilostazol improved absolute walking distance at 6 and 24 weeks (86.4% vs. 14.1%, P = .049; 143% vs. 23.2%, P = .086). Arterial compliance and lipid profiles improved as did some QoL indices for cilostazol at 6 and 24 weeks. Blood indices were similar at baseline and at follow-up points for both treatment groups.

Conclusions: Cilostazol is a well-tolerated and efficacious treatment, which improves claudication distances in diabetic PAD patients with further benefits in arterial compliance, lipid profiles, and QoL.

Key Words: peripheral arterial disease • diabetes • cilostazol

This version was published on April 1, 2009

Vascular and Endovascular Surgery, Vol. 43, No. 2, 132-143 (2009)
DOI: 10.1177/1538574408328586
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