title: Cilostazol and atherogenic dyslipidemia: a clinically relevant effect?
abstract: BACKGROUND
  Cilostazol is a reversible, selective inhibitor of PDE3A able to significantly improve walking distance in patients with intermittent claudication. However, beyond its antiplatelet and vasodilator properties, cilostazol seems to have significant effects on atherogenic dyslipidemia.
  
  
  METHODS
  The effects of cilostazol on plasma lipids, lipoproteins, apolipoproteins and postprandial lipemia are reviewed. A literature search (using Medline and Scopus) was performed up to 24 October 2010. The authors also manually reviewed the references of selected articles for any pertinent material.
  
  
  CONCLUSIONS
  Cilostazol is able to significantly lower plasma triglyceride levels, with a concomitant increase in high-density lipoprotein (HDL) cholesterol concentrations. Additional effects on pro-atherogenic lipoproteins and apolipoproteins include those on remnant-like particles, HDL subclasses, apolipoprotein B and postprandial lipemia. Cilostazol can improve the pro-atherogenic lipid profile in patients with peripheral arterial disease or type 2 diabetes. Further studies are needed to establish whether cilostazol treatment exerts clinically relevant effects on atherogenic dyslipidemia in high-risk patients.
authors.affiliation: Dipartimento di Medicina Interna e Specialistica DIMIS, Universitá di Palermo, Via del Vespro 141, Palermo, Italy. mrizzo@unipa.it
authors.forename: Manfredi
authors.initials: M
authors.lastname: Rizzo
authors.forename: Egle
authors.initials: E
authors.lastname: Corrado
authors.forename: Angelo Maria
authors.initials: AM
authors.lastname: Patti
authors.forename: Giovam Battista
authors.initials: GB
authors.lastname: Rini
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
mesh_terms: D050197:Atherosclerosis / Q000188:drug therapy* / Q000209:etiology; D000077407:Cilostazol; D054684:Cyclic Nucleotide Phosphodiesterases, Type 3 / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy; D050171:Dyslipidemias / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008055:Lipids / Q000097:blood; D058729:Peripheral Arterial Disease / Q000150:complications / Q000188:drug therapy; D058987:Phosphodiesterase 3 Inhibitors / Q000494:pharmacology*; D013777:Tetrazoles / Q000494:pharmacology*
chemical_list: D008055:Lipids; D058987:Phosphodiesterase 3 Inhibitors; D013777:Tetrazoles; D054684:Cyclic Nucleotide Phosphodiesterases, Type 3; C517287:PDE3A protein, human; D000077407:Cilostazol