The Effect of Cilostazol on Electrocardiographic Parameters in Patients with Peripheral Artery Disease Initiating Cilostazol Treatment

Abstract

Introduction: One of the pharmacological treatment options for improving the symptoms of peripheral artery disease (PAD) and increasing the quality of life is cilostazol. Cilostazol is a pharmacological agent that shows vasodilator activity mainly by reducing cAMP degradation through specific cellular phosphodiesterase 3A enzyme inhibition. The effect of cilostazol on electrocardiographic parameters is not clear. In this study, we aimed to examine the effect of cilostazol on electrocardiographic parameters in PAD patients. Patients and Methods: The study included a total of 32 patients diagnosed with intermittent claudication and peripheral artery disease (PAD), who were selected for medical treatment based on peripheral artery imaging. The subjects were started on 100 mg of cilostazol twice a day. The electrocardiographic measurements of the subjects before the cilostazol treatment and three months after the initiation of cilostazol were compared. Results: After a period of three months, statistically significant prolongation was observed in the ventricular repolarization parameters QTd, QTc, and Tpe of the subjects compared to their premedication values (p= 0.01, for all). Conclusion: It is known that patients with peripheral artery disease (PAD) are at an increased risk of major adverse cardiovascular events (MACE), including sudden cardiac death (SCD). In this context, close monitoring of electrocardiography markers for ventricular repolarization heterogeneity, such as QTd, QTc, and Tpe, is necessary when initiating cilostazol therapy in patients with peripheral artery disease (PAD). These markers may be closely associated with major adverse cardiovascular events (MACE), including sudden cardiac death (SCD), and therefore require careful monitoring in PAD patients receiving cilostazol treatment.