Effect of cilostazol on carotid plaque volume measured by 3D ultrasound in patients with type 2 diabetes: FANCY study

AIMS We conducted a prospective randomized study to evaluate cilostazol, a phosphodiesterase III inhibitor, and compare it with aspirin for the prevention of the progression of atherosclerosis in patients with type 2 diabetes (T2D). MATERIALS AND METHODS Fifty patients with T2D and carotid atherosclerotic plaques were randomly assigned to either 200 mg/day cilostazol (CTZ) or 100 mg/day aspirin (ASA) groups for 6 months. The primary end point was change in plaque volume measured by carotid 3D ultrasound. The secondary end points were changes in carotid intima-media thickness (IMT) and endothelial functions assessed by laser Doppler. RESULTS Twenty-four patients in the CTZ group and 23 in the ASA group were included in the final analysis. The mean age of male (n = 20) and female (n = 16) patients was 62.2 and 59.1 years, respectively. The total plaque volume was slightly decreased in the CTZ group (from 183.8 ± 52.5 to 181.5 ± 54.0 mm3 , P = 0.567), but significantly increased in the ASA group (from 112.9 ± 21.2 to 128.5 ± 23.3 mm3 , P = 0.043). A significant regression in the maximum IMT was observed only in the CTZ group (right: from 2.19 ± 0.17 to 1.96 ± 0.12 mm; left: from 2.02 ± 0.20 to 1.72 ± 0.19 mm). The CTZ group exhibited an increase in HDL-cholesterol and a decrease in triglycerides and liver enzymes. CONCLUSIONS Cilostazol treatment for 6 months significantly attenuated the progression of carotid plaque compared with aspirin in patients with T2D (NCT03248401). This article is protected by copyright. All rights reserved.