관상동맥 중재술을 받은 환자에서 실로스타졸 사용 후 동맥경직도의 변화

• Published in: The Korean journal of medicine Vol. 89; no. 3; pp. 295 - 304
• Main Authors: 조상영, Sang Young Cho, 김계환, Kye Hwan Kim, 안종화, Jong Hwa Ahn, 강영란, Young Ran Kang, 고진신, Jin Sin Koh, 황석재, Seok Jae Hwang, 박용휘, Yongwhi Park, 정영훈, Young Hoon Jeong, 곽충환, Choong Hwan Kwak, 황진용, Jin Yong Hwang, 박정랑, Jeong Rang Park
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 30.09.2015
• Subjects: Arterial stiffness; Augmentation index; Cilostazol; 내과학
• ISSN: 1738-9364; 2289-0769
• DOI: 10.3904/kjm.2015.89.3.295

Background/Aims: Increased arterial stiffness is a well-known risk factor for cardiovascular disease. Cilostazol, a phosphodiesterase type 3 inhibitor, is a unique antiplatelet agent with vasodilatory and vasoprotective effects. Therefore, we hypothesized that cilostazol may affect arterial stiffness. Methods: We enrolled 161 patients (112 males; mean age, 63 years) who had undergone percutaneous coronary intervention (PCI) for ischemic heart disease. The brachial-ankle pulse wave velocity (baPWV), radial augmentation index (rAI), rAI adjusted for a heart rate of 75 beats/min (rAI75), central systolic blood pressure (cSBP), and central pulse pressure (cPP), were measured at baseline and at the 30-day follow-up. Parameter changes were compared between the cilostazol group (n = 51) and the control group (n = 110). Results: In the cilostazol group, the values for rAI, cSBP, and cPP all improved after 30 days, while the control group displayed no significant interval changes in these parameters. The changes in rAI75 and baPWV did not differ significantly between the two groups. The changes in rAI, cSBP, and cPP were related to brachial systolic blood pressure, brachial diastolic blood pressure, heart rate, and the use of cilostazol and beta-blockers. In a multivariate analysis, the use of cilostazol was identified an independent factor associated with changes in rAI, cSBP, and cPP. Conclusions: The addition of cilostazol to conventional antiplatelet therapy in patients undergoing PCI may be associated with improvements in rAI, cSBP, and cPP, but not in rAI75 or baPWV. Therefore, the effects of cilostazol might be related to an increased heart rate. (Korean J Med 2015;89:295-304)