# CLIP-HFpEF: cilostazol bij HFpEF — gerandomiseerde trial

*geplaatst 2025-04-01 · Hartfalen · ESC heart failure · doi 10.1002/ehf2.15162 · https://hartvaat.nl/2025/04/01/clip-hfpef-cilostazol-bij-hfpef-gerandomiseerde-trial/*

De CLIP-HFpEF trial onderzocht cilostazol bij HFpEF. Het middel verbeterde de inspanningscapaciteit niet significant. PDE3-remming is niet effectief als HFpEF-therapie.

## English: Cilostazol in patients with heart failure and preserved ejection fraction-The CLIP-HFpEF trial.

The CLIP-HFpEF trial evaluated cilostazol, an oral PDE-3 inhibitor, in patients with heart failure with preserved ejection fraction. The drug did not significantly improve exercise capacity or health status, indicating that PDE-3 inhibition is not an effective therapeutic strategy for HFpEF.

## Abstract (original, from the publication)

BACKGROUND AND AIMS: Patients with heart failure with preserved ejection fraction (HFpEF) tend to have low resting and exercise heart rates. Phosphodiesterase-3 (PDE-3) inhibitors improve heart rates, haemodynamics and symptoms in patients with HFpEF. Cilostazol is an oral PDE-3 inhibitor used in peripheral artery disease. This study thought to evaluate the short-term effects of cilostazol on health status, N-terminal brain natriuretic peptide (NT-proBNP) levels and mechanisms of action. METHODS: The effect of cilostazol was evaluated in 23 patients with HFpEF in a randomized placebo controlled multiple crossover trial (CLIP-HFpEF). Participants received placebo or cilostazol for 1 week followed by three crossovers to the alternate assignment at weeks 2, 3 and 4. The primary endpoint was the Kansas City Cardiomyopathy Questionnaire (KCCQ-12) overall summary score obtained at the end of each treatment period. NT-proBNP was the secondary endpoint. In an exploratory mechanistic analysis, pulmonary artery (PA) pressures and heart rates were followed amongst the five participants with implanted pressure monitors. RESULTS: Cilostazol improved the KCCQ score by 4.8 points (95% confidence interval, 2.0-7.7, P = 0.003). NT-proBNP levels were 448 (154-1056) pg/mL on placebo and 375 (68-974) pg/mL on cilostazol (P = 0.006). In patients with PA pressure monitors, diastolic pressure was 20.5 (18.7-23.0) mmHg on placebo and 18.0 (17.0-20.0) mmHg on cilostazol, an effect linked to higher heart rates (P < 0.001). CONCLUSIONS: Amongst patients with HFpEF, short-term treatment with cilostazol leads to improvements in health status and NT-proBNP when compared with placebo. These effects are likely conveyed by a heart rate-dependent reduction in cardiac filling pressures. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05126836.

Auteurs: Norman Aiad, Jeanne du Fay de Lavallaz, Michael J Zhang, Thanat Chaikijurajai, Bo Ye, Prabhjot S Nijjar, Julie A Lahiri, Cindy M Martin, Tamas Alexy, Markus Meyer

---
Bron: ESC heart failure, https://doi.org/10.1002/ehf2.15162. Bijgewerkt 2026-07-03T13:30:34Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.