The Impact of Cilostazol in Refractory Vasospastic Angina.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology Pub Date : 2025-02-27 DOI:10.1159/000544943

Richard Z Lin, Rosanna Tavella, Sepehr Shakib, John F Beltrame

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引用次数: 0

Abstract

Introduction: Refractory vasospastic angina (VSA) includes patients with disabling angina despite maximally tolerated calcium channel blocker and nitrate therapy. Randomised clinical trial evidence confirms the efficacy of cilostazol in refractory VSA, yet its use in real-world clinical practice is limited. This study evaluated the impact of cilostazol therapy on patient-reported outcomes in patients with refractory VSA.

Methods: Between June 2016 and May 2022, 15 consecutive refractory VSA patients were initiated on cilostazol (50 mg twice daily), with baseline and 3-month responses assessed via the Seattle Angina Questionnaire (SAQ). The primary outcome was a clinically significant reduction in angina frequency (i.e., >10-point improvement in SAQ angina frequency score) at 3 months.

Results: A clinically significant reduction in angina frequency was reported in 13 patients (86%) at 3 months, with 3 (20%) becoming angina free. Moreover, over 3 months, median SAQ scores improved for angina frequency (25 [IQR 15, 46] to 75 [30, 82]), physical limitation (53 [44, 67] to 83 [56, 92]), and quality of life (17 [4, 29] to 50 [35, 58]). Additionally, a 54% reduction in angina-related emergency department presentations and 50% reduction in angina-related hospital admissions were noted. Minor medication-related adverse effects were experienced by 3 patients, with no serious adverse effects noted. Cilostazol was continued in 14 patients (93%) beyond the 3-month follow-up period.

Conclusions: In patients with refractory VSA, cilostazol is well tolerated, improves patient-reported outcomes, reduces healthcare utilisation, and thus is an effective therapy in real-world clinical practice.

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西洛他唑对难治性血管痉挛性心绞痛的影响。

难治性血管痉挛性心绞痛（VSA）包括尽管钙通道阻滞剂和硝酸盐治疗具有最大耐受性的致残性心绞痛患者。随机临床试验证据证实西洛他唑治疗难治性VSA的有效性，但其在实际临床实践中的应用有限。本研究评估了西洛他唑治疗对难治性VSA患者报告预后的影响。方法在2016年6月至2022年5月期间，连续15例难治性VSA患者开始服用西洛他唑（50mg，每日两次），并通过西雅图心绞痛问卷（SAQ）评估基线和3个月的反应。主要结局是3个月时心绞痛频率临床显著降低（即SAQ心绞痛频率评分提高10分）。结果13例患者（86%）在3个月时心绞痛发生率显著降低，其中3例（20%）心绞痛消失。此外，在3个月内，SAQ评分中位数在心绞痛频率（25 [IQR 15,46]至75[30,82]）、身体限制（53[44,67]至83[56,92]）和生活质量（17[4,29]至50[35,58]）方面均有所改善。此外，心绞痛相关的急诊科报告减少了54%，心绞痛相关的住院率减少了50%。3例患者出现轻微药物相关不良反应，未见严重不良反应。14例患者（93%）在超过3个月的随访期间继续使用西洛他唑。结论：对于难治性VSA患者，西洛他唑耐受性良好，改善患者报告的结果，减少医疗保健利用，因此在现实世界的临床实践中是一种有效的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.