College of Pharmacy, Ajou University, Suwon, Republic of Korea.
Department of Psychiatry, Ajou University, School of Medicine, Suwon, Republic of Korea.
J Alzheimers Dis. 2018;63(2):635-644. doi: 10.3233/JAD-170895.
Ischemic heart disease (IHD) is associated with cognitive decline and may contribute to an increased risk of dementia.
The goal of the present study was to investigate whether cilostazol use is associated with a lower risk of incident dementia in Asian patients with IHD, and whether these effects differed based on sex.
This retrospective cohort study was performed using the Korean National Insurance Claim Data of the Health Insurance Review and Assessment Service; the duration of the study was from January 1, 2007 to December 31, 2015. The study group comprised 66,225 patients with IHD, aged >65 years, who had received cilostazol. Age- and sex-matched IHD patients without cilostazol exposure were selected as the control group. The risk of dementia was compared between the cilostazol and control groups.
Compared to the control group, total cilostazol users had a marginally significant lower risk of incident dementia. After stratification by sex, the reducing effect of cilostazol on incident dementia was significant in female participants, but not in male participants. Female patients who had cilostazol for over 2 years showed a clinically meaningful preventive effect (HR, 0.85; 95% CI, 0.82-0.88).
This study suggested that cilostazol treatment may reduce the risk of incident dementia in Korean patients with IHD. Its beneficial effect was remarkably significant in female patients who received cilostazol for over a 2-year period.
缺血性心脏病（IHD）与认知能力下降有关，并且可能会增加痴呆的风险。
本研究旨在调查在患有 IHD 的亚洲患者中，西洛他唑的使用是否与痴呆的发生风险降低相关，以及这些作用是否因性别而异。
本回顾性队列研究使用了健康保险审查与评估服务的韩国国家保险索赔数据；研究时间为 2007 年 1 月 1 日至 2015 年 12 月 31 日。研究组包括 66225 名年龄>65 岁、接受西洛他唑治疗的 IHD 患者。选择未暴露于西洛他唑的年龄和性别匹配的 IHD 患者作为对照组。比较西洛他唑组和对照组的痴呆风险。
与对照组相比，总西洛他唑使用者发生痴呆的风险显著降低。按性别分层后，西洛他唑对女性参与者发生痴呆的降低作用有显著意义，但对男性参与者没有显著意义。西洛他唑使用超过 2 年的女性患者显示出有临床意义的预防效果（HR，0.85；95%CI，0.82-0.88）。
本研究表明，西洛他唑治疗可能降低韩国 IHD 患者发生痴呆的风险。对于使用西洛他唑超过 2 年的女性患者，其有益作用非常显著。
