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DAPC: Cilostazol inhibited carotid intima-media thickness in setting of type 2 diabetes
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Cilostazol compared with aspirin reduced the progression of carotid intima-media thickness in patients with type 2 diabetes, according to findings from the DAPC study.
Researchers from Japan and Korea conducted this prospective, randomized, blinded endpoint study in four eastern Asian countries. The patients with type 2 diabetes (n=329) and suspected peripheral arterial disease were assigned to either an aspirin treatment group (81-100 mg/d; n=166) or a cilostazol treatment group (100-200 mg/d; n=163). After 32 patients were excluded for withdrawing consent, dropping out before treatment or having no baseline intima-media thickness, 297 patients remained for final analysis (n=152 for aspirin; n=145 for cilostazol).
Patients treated with cilostazol (Pletal, Otsuka Pharmaceuticals) showed a greater regression in maximum left (–0.088 ± 0.260 vs. 0.059 ± 0.275 mm, P<.001), maximum right (–0.042 ± 0.274 vs. 0.045 ± 0.216 mm, P=.003), mean left (–0.043 ± 0.182 vs. 0.028 ± 0.202 mm, P=.004) and mean right (–0.024 ± 0.182 vs. 0.048 ± 0.169 mm, P<.001) common carotid artery intima-media thickness compared to those taking aspirin. Additionally, researchers reported no significant differences between the two groups in major CV events.
“Cilostazol potently inhibited progression of carotid intima-media thickness, an established surrogate marker of CV events, in patients with type 2 diabetes mellitus suspected of having PAD compared with aspirin,” the researchers wrote. “A large-scale prospective trial is needed to establish the usefulness of cilostazol for primary prevention of cardiovascular events in patients with type 2 diabetes mellitus.”
Katakami N. Circulation. 2010;121:2584-2591.
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