Abstract 18772: Combined Therapeutic Effect of Probucol and Cilostazol on Endothelial Function in Patients with Silent Cerebral Lacunar Infarcts and Hypercholesterolemia
Flow-mediated dilation (FMD) and nitroglycerin-induced dilation (NMD) in brachial artery is excellent modality for evaluating endothelial function (ECF), and silent lacunar cerebral infarcts (SLCI) detected by MRI complicated with hyperlcholesterolemia is associated with untoward prognosis for cardiovascular events through impaired ECF. To investigate if combined therapy of probucol and cilostazol can ameliorate ECF in SLCI with mild hyperlcholesterolemia (MH; LDL-c> 100 mg/dL), we measured FMD and NMD by UNEXEF18G before and after 4-weeks combined treatment of probucol (500 mg/day) and cilostazol (200 mg/day) in 24 patients with SLCI and MH (72±7 years old) with impaired ECF (FMD<6%). Patients were randomly allocated into two treatment arms such as aspirin (100 mg/day) with behavioral modification such as diet and/or exercise therapy (A-group, n=17) and probucol and cilostazol treatment (PC-group, n=17) with behavioral modification. Although baseline FMD were not different between two treatment arms (2.7±1.5 vs. 2.6±1.5%, NS), PC-group significantly improved FMD (from 2.6±1.5 to 3.5±1.7%, P<0.05) whereas A-group had no effect on FMD (from 2.6±1.2 to 2.9±1.4%, NS).There were no different effects in NMD in two groups. Effects of treatments on lipid profiles were more profound in PC-group. Conclusions; Combined treatment of probucol and cilostazol can subacutely ameliorate ECF detected by FMD in SLCI with MH. This combination therapy possibly prevents further cardiovascular events through improving both ECF and lipid profiles.
- © 2012 by American Heart Association, Inc.