Cilostazol in the management of vascular disease.
Cilostazol is a potent type III phosphodiesterase inhibitor with pharmacological effects that include vasodilatation, inhibition of platelet activation and aggregation, inhibition of thrombosis, increased blood flow to the limbs, improvement in serum lipids with lowering of triglycerides and elevation of high density lipoprotein cholesterol, and inhibition of vascular smooth muscle cell growth. It operates through its action as endothelium-target antithrombotic therapy, achieving its effects by improving endothelial cell function and reducing the number of platelets partially activated by interacting with activated endothelial cells. Since receiving approval from the Food and Drug Administration in 1999 in the United States for the treatment on intermittent claudication secondary to peripheral arterial disease, new data on its role on the prevention of restenosis after percutaneous transluminal angioplasty and the secondary prevention of cerebral infarction have increased interest in the drug. The aim of this study is to review cilostazol's beneficial effects and adverse events, and to present the results of the major clinical trials.
Dalainas
I
I
Unit of Vascular Surgery, University of Milan, Milan, Italy. hdlns@freemail.gr
D015105:3',5'-Cyclic-AMP Phosphodiesterases / Q000037:antagonists & inhibitors* / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000201:enzymology / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000188:drug therapy; D000077407:Cilostazol; D054684:Cyclic Nucleotide Phosphodiesterases, Type 3; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000201:enzymology / Q000503:physiopathology; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006331:Heart Diseases / Q000188:drug therapy; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000188:drug therapy; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D013777:Tetrazoles / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*
D005343:Fibrinolytic Agents; D010726:Phosphodiesterase Inhibitors; D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D014665:Vasodilator Agents; D015105:3',5'-Cyclic-AMP Phosphodiesterases; D054684:Cyclic Nucleotide Phosphodiesterases, Type 3; D000077407:Cilostazol