DAPC: Cilostazol inhibited carotid intima-media thickness in setting of type 2
diabetes
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.
