Key result
One-year cilostazol is linked to reduced carotid IMT but fails to change total plaque area.
Why the study?
Cilostazol has been proposed to have beneficial effects in the prevention of atherosclerosis, but its effects on carotid atherosclerosis in patients with retinal vascular occlusion were not established.
Does cilostazol reduce carotid intima-media thickening and total plaque area in patients with retinal vascular occlusion?
Observational (n=63)
Does cilostazol reduce carotid intima-media thickening and total plaque area in patients with retinal vascular occlusion?
Absolute Event Rate: 0.45% vs 0.61%
p-value: p=0.291
Cilostazol may inhibit the progression of carotid IMT and promote early carotid plaque regression in patients with retinal vascular occlusion.
Cilostazol-associated IMT reduction in retinal vascular occlusion should not yet change practice; hypothesis-generating and requires randomized confirmation.
BACKGROUND: Cilostazol, a selective phosphodiesterase three inhibitor, has been proposed to have beneficial effects in the prevention of atherosclerosis. AIMS: We aimed to investigate the effects of cilostazol on carotid intima-media thickening (IMT) and total plaque area (TPA) in patients with retinal vascular occlusion. METHODS: A total of 63 consecutive vascular occlusive retinopathy patients with carotid atherosclerosis were enrolled. We examined changes in the carotid IMT/TPA and visual acuity/macular thickness before and after 1-year treatment with cilostazol (200 mg/day). RESULTS: The mean IMT of both common carotid arteries (CCAs) and internal carotid arteries (ICAs) were significantly reduced after cilostazol treatment. There was no significant difference in the TPA of both CCAs before and after the treatment (before; 0.61 ± 0.94 vs. after; 0.45 ± 0.79 cm(2) , P = 0.291); however, significant plaque regression (before; 0.14 ± 0.15 vs. after; 0.25 ± 0.14 cm(2) , P = 0.004) was observed in selected patients (n = 30) with a TPA <0.5 cm(2) . The improvement in macular thickness was significantly associated with an improvement in carotid IMT (r = 0.42, P = 0.001) and TPA (r = 0.23, P = 0.04). CONCLUSION: Cilostazol potently inhibited the progression of carotid IMT and may play a role in the early carotid plaque regression in patients with retinal vascular occlusion.
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Kim et al. (2013) conducted an observational in Retinal vascular occlusion with carotid atherosclerosis (n=63). Cilostazol vs. Before treatment (baseline) was evaluated on Total plaque area (TPA) of both common carotid arteries (p=0.291). One-year treatment with cilostazol significantly reduced mean carotid IMT but did not significantly change total plaque area overall (0.45 vs 0.61 cm2 at baseline; P=0.291).
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