OBJECTIVE: To compare the efficacy of cilostazol and aspirin in reducing carotid intima-media thickness（ IMT） in patients with type 2 diabetes mellitus（ T2DM） by monitoring the carotid IMT by carotid ultrasound.METHODS: Totally 312 patients with T2DM who had risk factors for cardiovascular events admitted into the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College were extracted to be divided into the aspirin group（ n = 156） and the cilostazol group（ n = 156） via the random number table.The aspirin group was treated with Aspirin tablets

100 mg for once

qd; the cilostazol group received Cilostazol tablets

100 mg for once

bid.The observation and treatment cycle was 3 years.The patients were followed up

and the left-side carotid average IMT

leftside carotid maximum IMT( IMT

max

)

right-side carotid average IMT and right-side carotid IMT

max

were compared between two groups at baseline

1

2 and 3 years of follow-up.The clinical and biochemical indicators of two groups at baseline and after 3 years of follow-up were recorded and compared

and the mortality

major adverse cardiovascular events（ MACE）

and incidence of adverse drug reactions between two groups were compared.RESULTS: After 1

2 and 3 years of follow-up

the left-side carotid average IMT

left-side carotid IMT

max

right-side carotid average IMT and right-side carotid IMT

max

of cilostazol group were significantly lower than those of the baseline

and significantly lower than those of the aspirin group

the differences were statistically significant（ P

<

0.05）.After treatment

highdensity lipoprotein cholesterol（ HDL） levels（ t = 2.700

P = 0.007）

25-hydroxyvitamin D

3

[25（ OH） D

3

] levels（ t= 4.605

P

<

0.007） and the proportion of patients with statins（ χ

2

= 6.741

P = 0.009） in the cilostazol group were significantly higher than that of the baseline.The HDL levels（ t = 2.354

P = 0.019）

25（ OH） D

3

levels（ t = 3.096

P = 0.002） and the proportion of patients with statins（ χ

2

= 4.446

P = 0.035） in the celotazole group were significantly higher than those in the aspirin group

and the differences were statistically significant.There was no significant difference in mortality

incidence of major adverse cardiovascular events or adverse drug reactions between two groups（ P

>

0.05）.CONCLUSIONS: Compared with aspirin

cilostazol can significantly reduce IMT in T2DM patients with high risk factors for cardiovascular events

inhibit plaque formation and improve atherosclerosis through vasodilation and antiplatelet.