Cilostazol: a Review of Basic Mechanisms and Clinical Uses

Primarily used in the treatment of intermittent claudication, cilostazol is a 2-oxyquinolone derivative that works through the inhibition of phosphodiesterase III and related increases in cyclic adenosine monophosphate (cAMP) levels. However, cilostazol has been implicated in a number of other basic...

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Published in:Cardiovascular drugs and therapy Vol. 36; no. 4; pp. 777 - 792
Main Authors: Kherallah, Riyad Y., Khawaja, Muzamil, Olson, Michael, Angiolillo, Dominick, Birnbaum, Yochai
Format: Journal Article
Language:English
Published: New York Springer US 01.08.2022
Springer Nature B.V
Subjects:
Adenosine diphosphate
Adenosine monophosphate
Aspirin
Blood platelets
Cardiology
Cardiovascular disease
Cardiovascular diseases
Cardiovascular system
Cyclic AMP
Diabetes
Enzymes
Intermittent claudication
Intervention
Ischemia
Kinases
Medicine
Medicine & Public Health
Multidrug resistance
Phosphodiesterase
Phosphorylation
Population studies
Proteins
Reperfusion
Restenosis
Review Article
Smooth muscle
Phosphodiesterase inhibitor
Platelet inhibition
Cilostazol
ISSN:0920-3206, 1573-7241, 1573-7241
Online Access:Get full text
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Summary:Primarily used in the treatment of intermittent claudication, cilostazol is a 2-oxyquinolone derivative that works through the inhibition of phosphodiesterase III and related increases in cyclic adenosine monophosphate (cAMP) levels. However, cilostazol has been implicated in a number of other basic pathways including the inhibition of adenosine reuptake, the inhibition of multidrug resistance protein 4, among others. It has been observed to exhibit antiplatelet, antiproliferative, vasodilatory, and ischemic-reperfusion protective properties. As such, cilostazol has been investigated for clinical use in a variety of settings including intermittent claudication, as an adjunctive for reduction of restenosis after coronary and peripheral endovascular interventions, and in the prevention of secondary stroke, although its widespread implementation for indications other than intermittent claudication has been limited by relatively modest effect sizes and lack of studies in western populations. In this review, we highlight the pleiotropic effects of cilostazol and the evidence for its clinical use.
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ISSN:0920-3206
1573-7241
1573-7241
DOI:10.1007/s10557-021-07187-x