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Cilostazol increases patency and reduces adverse outcomes in percutaneous femoropopliteal revascularisation: a meta-analysis of randomised controlled trials.

Benjo AM, Garcia DC, Jenkins JS, Cardoso RM, Molina TP, El-Hayek GE, Nadkarni GN, Aziz EF, Dinicolantonio JJ, Collins T - Open Heart (2014)

Bottom Line: Death and amputation were not different in between groups.Cilostazol significantly increases femoropopliteal patency and decreases adverse outcomes in percutaneous endovascular intervention.However, further RCTs are needed because of limited sample size; this meta-analysis represents the best current evidence.

View Article: PubMed Central - PubMed

Affiliation: Division of Interventional Cardiology , Ochsner Medical Center , New Orleans, Louisiana , USA.

ABSTRACT

Background: Cilostazol is an oral antiplatelet agent currently indicated for treatment of intermittent claudication. There is evidence that cilostazol may reduce femoropopliteal restenosis after percutaneous endovascular intervention.

Methods: We searched PubMed, Scopus and Cochrane databases from 1966 through September 2013 for randomised controlled trials (RCTs) evaluating the addition of cilostazol to standard care in patients receiving femoropopliteal endovascular treatment. Restenosis, target lesion revascularisation and combined adverse outcomes (death, revascularisation and amputation) within 1-2 years postprocedure were evaluated.

Results: Of 205 articles, three RCTs were included in the analysis. The pooled data provided a total of 396 patients, 195 of whom received cilostazol. When compared to standard medical therapy alone, cilostazol significantly reduced the risk of restenosis (risk difference -0.20; 95% CI -0.29 to -0.11; p<0.0001; number needed to treat 5), target lesion revascularisation (risk difference -0.17; 95% CI -0.25 to -0.09; p<0.0001; number needed to treat 6). Death and amputation were not different in between groups.

Conclusions and limitation: Cilostazol significantly increases femoropopliteal patency and decreases adverse outcomes in percutaneous endovascular intervention. However, further RCTs are needed because of limited sample size; this meta-analysis represents the best current evidence.

No MeSH data available.


Related in: MedlinePlus

Studies selection.
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OPENHRT2014000154F1: Studies selection.

Mentions: The process of study selection is shown in figure 1. Initial MEDLINE search using a systematic approach yielded 205 studies. The search in EMBASE and Cochrane registries did not yield additional studies. Through a review of titles and abstracts, 173 studies were rejected due to lack of relevance to our meta-analysis. The remaining 32 articles were reviewed and assessed for satisfaction of the inclusion or exclusion criteria. Three studies met all criteria and were included in this analysis.


Cilostazol increases patency and reduces adverse outcomes in percutaneous femoropopliteal revascularisation: a meta-analysis of randomised controlled trials.

Benjo AM, Garcia DC, Jenkins JS, Cardoso RM, Molina TP, El-Hayek GE, Nadkarni GN, Aziz EF, Dinicolantonio JJ, Collins T - Open Heart (2014)

Studies selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4225296&req=5

OPENHRT2014000154F1: Studies selection.
Mentions: The process of study selection is shown in figure 1. Initial MEDLINE search using a systematic approach yielded 205 studies. The search in EMBASE and Cochrane registries did not yield additional studies. Through a review of titles and abstracts, 173 studies were rejected due to lack of relevance to our meta-analysis. The remaining 32 articles were reviewed and assessed for satisfaction of the inclusion or exclusion criteria. Three studies met all criteria and were included in this analysis.

Bottom Line: Death and amputation were not different in between groups.Cilostazol significantly increases femoropopliteal patency and decreases adverse outcomes in percutaneous endovascular intervention.However, further RCTs are needed because of limited sample size; this meta-analysis represents the best current evidence.

View Article: PubMed Central - PubMed

Affiliation: Division of Interventional Cardiology , Ochsner Medical Center , New Orleans, Louisiana , USA.

ABSTRACT

Background: Cilostazol is an oral antiplatelet agent currently indicated for treatment of intermittent claudication. There is evidence that cilostazol may reduce femoropopliteal restenosis after percutaneous endovascular intervention.

Methods: We searched PubMed, Scopus and Cochrane databases from 1966 through September 2013 for randomised controlled trials (RCTs) evaluating the addition of cilostazol to standard care in patients receiving femoropopliteal endovascular treatment. Restenosis, target lesion revascularisation and combined adverse outcomes (death, revascularisation and amputation) within 1-2 years postprocedure were evaluated.

Results: Of 205 articles, three RCTs were included in the analysis. The pooled data provided a total of 396 patients, 195 of whom received cilostazol. When compared to standard medical therapy alone, cilostazol significantly reduced the risk of restenosis (risk difference -0.20; 95% CI -0.29 to -0.11; p<0.0001; number needed to treat 5), target lesion revascularisation (risk difference -0.17; 95% CI -0.25 to -0.09; p<0.0001; number needed to treat 6). Death and amputation were not different in between groups.

Conclusions and limitation: Cilostazol significantly increases femoropopliteal patency and decreases adverse outcomes in percutaneous endovascular intervention. However, further RCTs are needed because of limited sample size; this meta-analysis represents the best current evidence.

No MeSH data available.


Related in: MedlinePlus