Long-acting cilostazol versus isosorbide mononitrate for patients with vasospastic angina: a randomized controlled trial.
Coron Artery Dis
; 35(6): 459-464, 2024 Sep 01.
Article
in En
| MEDLINE
| ID: mdl-38595079
ABSTRACT
BACKGROUND:
Cilostazol has a vasodilatory function that may be beneficial for patients with vasospastic angina (VSA). We conducted a randomized, open-label, controlled trial to compare the efficacy and safety of long-acting cilostazol and isosorbide mononitrate (ISMN) for VSA.METHODS:
The study included patients with confirmed VSA between September 2019 and May 2021. Participants were randomly assigned to receive long-acting cilostazol (test group, 200â mg once daily) or conventional ISMN therapy (control group, 20â mg twice daily) for 4â weeks. The clinical efficacy and safety were evaluated using weekly questionnaires.RESULTS:
Forty patients were enrolled in the study (long-acting cilostazol, n â =â 20; ISMN, n â =â 20). Baseline characteristics were balanced between the two groups. Long acting cilostazol showed better angina symptom control within the first week compared to ISMN [reduction of pain intensity score, 6.0 (4.0-8.0) vs. 4.0 (1.0-5.0), P â =â 0.005; frequency of angina symptom, 0 (0-2.0) vs. 2.0 (0-3.0), P â =â 0.027, respectively]. The rate of neurological adverse reactions was lower in the cilostazol group than in the ISMN group (headache or dizziness, 40 vs. 85%, P â =â 0.009; headache, 30 vs. 70%, P â =â 0.027).CONCLUSION:
Long-acting cilostazol provided comparable control of angina and fewer adverse neurologic reactions within 4â weeks compared to ISMN. Long-acting cilostazol provides more intensive control of angina within 1â week, suggesting that it may be an initial choice for the treatment of VSA.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Vasodilator Agents
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Coronary Vasospasm
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Cilostazol
/
Isosorbide Dinitrate
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Coron Artery Dis
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2024
Document type:
Article