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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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.