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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

Twelve-month to 24-month incidence of restenosis.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4225296&req=5

OPENHRT2014000154F2: Twelve-month to 24-month incidence of restenosis.

Mentions: For the primary outcome, as seen in figure 2, the follow-up revealed a significantly reduced incidence of restenosis in patients who received cilostazol in addition to standard medical (RD −0.20; 95% CI −0.29 to −0.11; p<0.0001; NNT 5). This was reflected on a reduced need for target lesion revascularisation (RD −0.17; 95% CI −0.25 to −0.09; p<0.0001; NNT 6) with a NNT of 5 for both outcomes (figure 3). We also conducted a sensitivity analysis utilising OR as the primary pooled estimate and the effect size did not change. Death and amputations did not statistically differ between the two groups.


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)

Twelve-month to 24-month incidence of restenosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

OPENHRT2014000154F2: Twelve-month to 24-month incidence of restenosis.
Mentions: For the primary outcome, as seen in figure 2, the follow-up revealed a significantly reduced incidence of restenosis in patients who received cilostazol in addition to standard medical (RD −0.20; 95% CI −0.29 to −0.11; p<0.0001; NNT 5). This was reflected on a reduced need for target lesion revascularisation (RD −0.17; 95% CI −0.25 to −0.09; p<0.0001; NNT 6) with a NNT of 5 for both outcomes (figure 3). We also conducted a sensitivity analysis utilising OR as the primary pooled estimate and the effect size did not change. Death and amputations did not statistically differ between the two groups.

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