Real world data from a multi-centre study on the effects of cilostazol on pain symptoms and walking distance in patients with peripheral arterial disease
Authors: Katsiki Niki , Tentolouris Nikolaos , Marakomichelakis Georgios , Richter Dimitrios , Giannoukas Athanasios , Koufaki Panagiota , Papanas Nikolaos ,   CI-WIN Investigators, Alexopoulos Ilias , Anastasiadis Filippos , Andreadis Evangelos , Andreopoulos Georgios , Apostolidis Dimitris , Christodoulou Ioannis , Christopoulos Ioannis , Dalaberis Eleftherios , Daliani Hermioni , Dimitriou Giorgos , Dimitsikoglou Iordanis , Dimoulis Nikolaos , Doulgerakis Dimitrios , Douloumpakas Ioannis , Drakopoulou Efrosyni , Felekis Theodoros , Feloukas Theodoros , Florou Sofia , Fragakis Dimitrios , Fregidis Theodoros , Gakis Panagiotis , Galanakis Christos , Giakoumis Antonios , Giannes Nikolaos , Galapis Alexandros , Gouveris Ioannis , Groutsis Theodoros , Grapsas Vasileios , Grigoropoulos Panagiotis , Iordanidis Triantafyllos , Kazakos Kyriakos , Kazantzi Maria , Kapernopoulos Haralabos , Kapetanios Konstantinos , Karagianni Eleni , Karakostas Fotis , Karapiperis Dimitris , Karotsis Antonios , Karsanidis Abraam , Kasfikis Fotios , Kourouklis Spyridon , Kourtis Tsampikos , Kourtidou Paraskevi , Koutsias Stylianos , Kotsogiannis Stavros , Lampousakis Ioannis , Latsios Panagiotis , Liouri Irine , Makrygiannis Panagiotis , Matsouki Welcome , Bakalakou Konstantina , Bakiris Pavlos , Balogianni Maria , Benis Apostolos , Beri Vasiliki , Beroukas Antonios , Moysidis Konstantinos , Nanos Efstathios , Nikolaou Achilleas , Dubovina Marina , Oikonomidis Nikolaos , Pangalos Emmanouil , Panagoulias Georgios , Papadopoulos Savvas , Paraskevas Georgios , Peroulis Michael , Petoumenos Vasilis , Petrogiannis Spyridon , Pournaras Georgios , Pourou Helena , Prionidis Markos , Rigas Antonios , Rigas Spyridon , Rigopoulos Dimitrios , Sakellariou Dimitrios , Sarafianos Periklis , Svolis Konstantinos , Seferou Maria , Sklirou Vasiliki , Spais Georgios , Stathopoulos Christos , Stavridou Victoria , Stavrou Ioannis , Sfiniadakis Ioannis , Tatola Vagia , Topalidis Isaak , Trikkalinou Aikaterini , Tsagarakis Dimitrios , Tsarouchas Panagiotis , Valkaniotis Georgios , Varella Maria , Vasilakakou Stavroula , Vlachopoulou Maria , Vouzas Antonios , Zafeiriou Ioannis , Zafeiris Ioannis , Zacharopoulou Ourania , Zinelis Dimosthenis 
Published: December 2022

Abstract
Objective
to assess the effects of cilostazol on pain-free walking distance in PAD patients with IC at 3 and 6 months in a real world, prospective, observational study. We included 1015 PAD patients presenting with IC (71.3% men, 93.5% white, mean age 69.2 ± 8.7 years). Patients were followed up for 6 months by their physicians.

Results
Cilostazol significantly increased pain-free walking distance by a median of 285 and 387 m at 3 and 6 months, respectively (p < 0.01 for all comparisons). This effect was significant for patients 50–74 years (but not for those aged ≥ 75 years) and independent of smoking status, changes in physical activity, comorbidities and concomitant medication for PAD (i.e., acetylsalicylic acid and clopidogrel). Furthermore, significant reductions were observed in systolic (from 139 ± 16 to 133 ± 14 mmHg; p < 0.001) and diastolic blood pressure (from 84 ± 9 mmHg to 80 ± 10 mmHg; p < 0.001). Smoking cessation and increased physical activity were reported by the majority of participants. In conclusion, cilostazol was shown to safely decrease pain symptoms and improve pain-free walking in PAD patients with IC in a real world setting. Benefits also occurred in terms of BP and lifestyle changes.