Abstract
Background: We used 3D ultrasonography, which gives the precise 3D morphology of carotid arterial plaques, to assess medical therapy for such plaques.
Cilostazol, an antiplatelet agent, is known to have a pleiotropic effect on the carotid arterial endothelium in addition to its antiplatelet effects. The purpose of the present study is to evaluate the effect of cilostazol on reducing carotid arterial plaques using 3D ultrasonography.
Method: The subjects were 21 patients with cerebral infarctions with carotid arterial plaques (M:F=16:5, mean age: 67±7) treated with cilostazol (200 mg daily). They had regular follow-ups at our out-patient clinic. Their medications were unchanged for over 3 months before the cilostazol administration. Measurement of plaque volumes and serological analyses of all subjects were performed 3 months after beginning administration and compared with those at the baseline.
The 3D plaque images were acquired using a Voluson 730 Expert (GE Health Care) with a 3D/4D probe.
Results: Among all subjects taking cilostazol, the carotid arterial plaque volume was reduced from 0.44±0.39 to 0.39±0.40 cm3 (p=0.005). Among the 19 subjects who did not show increased plaque volumes, serum high-density lipoprotein-cholesterol (HDL-C) was significantly increased from 59±22 to 65±23 mg/dl (p=0.017) in 3 months.
Conclusions: The present study using 3D ultrasonography showed that cilostazol reduces the volume of atherosclerotic carotid plaques within 3 months after administration. Among the subjects who did not show increased plaque volumes, serum HDL-C was significantly increased. The above data indicate that cilostazol reduces the volume of carotid arterial plaques and improves the lipid metabolism of the carotid arterial endothelium.
