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- Title
Role of Cilostazol Therapy in Hemodialysis Patients with Asymptomatic Peripheral Arterial Disease: A Retrospective Cohort Study.
- Authors
Lim, Paik Seong; Jeng, Yachung; Wu, Ming Ying; Pai, Mei-Ann; Wu, Tsai-Kun; Chen, Chang Hsu
- Abstract
Background. Peripheral arterial disease (PAD) and its relevant complications are more common in hemodialysis (HD) patients, while the evidence regarding antiplatelet therapy in CKD patients is scarce. We retrospectively analyzed the efficacy of cilostazol on outcomes in HD patients with asymptomatic PAD (aPAD). Methods. This cohort study enrolled 217 HD patients (median follow-up time: 5.75 years). Associations between cilostazol use and the outcomes were evaluated by time-dependent Cox regression analysis. Results. During follow-up, 39.5% (47/119) patients used cilostazol for aPAD and 31.8% (69/217) patients died. Cilostazol users had significantly lower CVD and all-cause mortalities (adjusted HR [95% CI]: 0.11 [0.03, 0.51] and 0.2 [0.08, 0.52]) than nonusers. Both death risks were nonsignificantly higher in cilostazol users than in HD patients without aPAD. The unadjusted and adjusted HR [95% CI] of CVD death risk were 0.4 [0.07, 2.12] and 0.14 [0.02, 0.8] for patients with aPAD during follow-up and were 0.74 [0.16, 3.36] and 0.19 [0.04, 0.93] for those with aPAD at initial. Conclusions. In HD patients with aPAD, lower CVD and all-cause mortality rates were observed in low-dose cilostazol user. Further evidences from large-scale prospective study and randomization trial are desired to confirm the effect of cilostazol.
- Subjects
TAIWAN; CARDIOVASCULAR disease related mortality; TREATMENT of chronic kidney failure; MORTALITY risk factors; CARDIOVASCULAR diseases risk factors; CONFIDENCE intervals; HEMODIALYSIS; PERIPHERAL vascular diseases; PROBABILITY theory; RESEARCH funding; TETRAZOLES; PROPORTIONAL hazards models; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; KAPLAN-Meier estimator; LOG-rank test; ODDS ratio; DISEASE complications; PREVENTION
- Publication
BioMed Research International, 2016, Vol 2016, p1
- ISSN
2314-6133
- Publication type
Article
- DOI
10.1155/2016/8236903