Efficacy of cilostazol for sick sinus syndrome to avoid permanent pacemaker implantation: A retrospective case–control study
Autor: | Sandeep Shakya, Junji Kanda, Satoshi Kodera, Takuryu Sonoura |
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Rok vydání: | 2019 |
Předmět: |
Male
Bradycardia Pacemaker Artificial medicine.medical_specialty 030204 cardiovascular system & hematology Sick sinus syndrome Prosthesis Implantation 03 medical and health sciences 0302 clinical medicine Heart Rate Internal medicine Heart rate Clinical endpoint Humans Medicine 030212 general & internal medicine Aged Retrospective Studies Sick Sinus Syndrome business.industry Case-control study Middle Aged medicine.disease Cilostazol SSS Treatment Outcome Case-Control Studies Multivariate Analysis Cardiology Female Permanent pacemaker medicine.symptom Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors medicine.drug |
Zdroj: | Journal of Cardiology. 74:328-332 |
ISSN: | 0914-5087 |
DOI: | 10.1016/j.jjcc.2019.03.007 |
Popis: | Currently, bradycardia treatment is limited to permanent pacemaker (PM) implantation. No consensus exists as to its optimal medication regimen. However, as cilostazol accelerates heart rate (HR) in bradycardia, we investigated its efficacy for sick sinus syndrome (SSS) to avoid permanent PM implantation.This was a retrospective, case-control study. We included 192 consecutive patients diagnosed with SSS (after applying some exclusion criteria), of whom 54 received cilostazol (cilostazol group) and 138 did not receive cilostazol (control group). The primary endpoint was the PM implantation rate after 6 months; secondary endpoints were 1- and 3-month PM implantation rates, HR after 1 week, 1 and 6 months, and cilostazol side effects.The 6-month PM implantation rate was lower in the cilostazol than the control group (20.4% vs. 55.8%, respectively; p0.001). In multivariate analysis, cilostazol decreased the 6-month PM implantation rate (OR: 0.22; 95% CI: 0.08-0.55; p=0.001). Although baseline HR was significantly lower in the cilostazol group, HR in this group increased and did not significantly differ between the two groups after 1 week, 1 and 6 months. In subgroup analyses of symptomatic patients, the PM implantation rates after 6 months were significantly lower in the cilostazol group than in the control group.Cilostazol was effective for symptomatic SSS to avoid PM implantation by increasing HR. |
Databáze: | OpenAIRE |
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