Background: Cilostazol, as phosphodiesterase inhibitor, has widely used as antiplatelet agent, which also has vasodilatory and vasoprotective effect. We hypothesized the use of cilostazol might effect on arterial stiffness, as well as platelet function. Therefore we investigate brachial-ankle pulse wave velocity (baPWV), radial augmentation index (AI), central systolic blood pressure (cSBP) and central pulse pressure (central PP) in patients undertaken percutaneous coronary intervention (PCI).
Method: We enrolled 133 patients (92men, mean age 64 years) performed PCI for ischemic heart disease consecutively. Patients with known and suspicious peripheral artery disease were excluded. The baPWV, radial AI, cSBP and central PP were measured before discharge and after 3 weeks. The changes of parameters for 3 weeks were compared between cilostazol group (n = 48) and control group (n = 85).
Results: In baseline characteristics, prevalence of hypertension and medication of calcium channel blocker were higher in cilostazol group than control group (60% vs. 41%, p = 0.046 and 42% vs. 24%, p = 0.032, respectively). In cilostazol group, AI, cSBP and central PP improved after 3 weeks (AI, 79.5 to. 71.5, p < 0.020; cSBP, 129.0 to 117.5, p < 0.040; central PP, 53.5 to 48.0, p = 0.047). The heart rate of cilostazol group was significantly increased (70.0 to 77.5, p = 0.009). The control group has no significant interval changes of arterial stiffness and heart rate. In compared cilostazol with control group, the changes of AI and central PP of cilostazol group were more reduced significantly. There was no difference of baPWV in both groups. However cilostazol was not independent factor of arterial stiffness on multivariate analysis.
Conclusion: Adding cilostazol to conventional antiplatelets tends to improve arterial stiffness as reduced AI, cSBP and central PP for 3weeks, as well as to potentiate antiplatelet effect.