Safety of cilostazol in peripheral artery disease: a cohort from a primary healthcare electronic database

BMC Cardiovasc Disord. 2018 May 8;18(1):85. doi: 10.1186/s12872-018-0822-4.

Abstract

Background: Cilostazol has been associated with spontaneous reports of cardiovascular adverse events and serious bleeding. The objective of this study is to determine the relative risk of cardiovascular adverse events or haemorrhages in patients with peripheral artery disease treated with cilostazol in comparison to pentoxifylline users.

Methods: Population-based cohort study including all individuals older than 40 who initiated cilostazol or pentoxifylline during 2009-2011 in SIDIAP database. The two treatment groups were matched through propensity score (PS).

Results: Nine thousand one hundred twenty-nine patients met inclusion criteria and after PS matching, there were 2905 patients in each group. 76% of patients were men, with similar mean ages in both groups (68.8 for cilostazol and 69.4 for pentoxifylline). There were no differences in bleeding, cerebrovascular and cardiovascular events between both groups.

Conclusions: Patients treated with cilostazol were different from those treated with pentoxifylline at baseline, so they were matched through PS. We did not find differences between treatment groups in the incidence of bleeding or cardiovascular and cerebrovascular events. Cilostazol should be used with precaution in elderly polymedicated patients.

Keywords: Arrhythmia; Cardiovascular events; Cilostazol; Coronary artery disease; Electronic health records; Haemorrhage; Pentoxifylline; Peripheral artery disease; Primary healthcare.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use*
  • Cerebrovascular Disorders / epidemiology
  • Cilostazol / adverse effects
  • Cilostazol / therapeutic use*
  • Databases, Factual
  • Drug Interactions
  • Electronic Health Records*
  • Female
  • Hemorrhage / chemically induced
  • Hemorrhage / epidemiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Patient Safety
  • Pentoxifylline / adverse effects
  • Pentoxifylline / therapeutic use*
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / drug therapy*
  • Peripheral Arterial Disease / epidemiology
  • Peripheral Arterial Disease / physiopathology
  • Phosphodiesterase 3 Inhibitors / adverse effects
  • Phosphodiesterase 3 Inhibitors / therapeutic use*
  • Polypharmacy
  • Primary Health Care*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Spain / epidemiology
  • Time Factors
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • Phosphodiesterase 3 Inhibitors
  • Cilostazol
  • Pentoxifylline