Key result
Cilostazol cuts adverse CV events in prior CAD or stroke and improves PAD ambulatory capacity.
Why the study?
Despite its wide spectrum of pharmacological effects, the role of cilostazol has not been clearly documented in many guidelines for atherosclerotic cardiovascular disease.
Does cilostazol reduce adverse cardiovascular events in individuals at high risk of ASCVD?
Does cilostazol reduce adverse cardiovascular events in individuals at high risk of ASCVD?
Cilostazol demonstrates broad cardiovascular benefits, including reducing adverse cardiovascular events, improving peripheral arterial disease symptoms, and mitigating in-stent restenosis in high-risk ASCVD patients.
May support cilostazol in high-risk ASCVD patients; leaves open confirmation by prospective RCTs.
Atherosclerotic cardiovascular disease (ASCVD) stands as the leading global cause of mortality. Addressing this vital and pervasive condition requires a multifaceted approach, in which antiplatelet intervention plays a pivotal role, together with antihypertensive, antidiabetic, and lipid-lowering therapies. Among the antiplatelet agents available currently, cilostazol, a phosphodiesterase-3 inhibitor, offers a spectrum of pharmacological effects. These encompass vasodilation, the impediment of platelet activation and aggregation, thrombosis inhibition, limb blood flow augmentation, lipid profile enhancement through triglyceride reduction and high-density lipoprotein cholesterol elevation, and the suppression of vascular smooth muscle cell proliferation. However, the role of cilostazol has not been clearly documented in many guidelines for ASCVD. We comprehensively reviewed the cardiovascular effects of cilostazol within randomized clinical trials that compared it to control or active agents and involved individuals with previous coronary artery disease or stroke, as well as those with no previous history of such conditions. Our approach demonstrated that the administration of cilostazol effectively reduced adverse cardiovascular events, although there was less evidence regarding its impact on myocardial infarction. Most studies have consistently reported its favorable effects in reducing intermittent claudication and enhancing ambulatory capacity in patients with peripheral arterial disease. Furthermore, cilostazol has shown promise in mitigating restenosis following coronary stent implantation in patients with acute coronary syndrome. While research from more diverse regions is still needed, our findings shed light on the broader implications of cilostazol in the context of atherosclerosis and vascular biology, particularly for individuals at high risk of ASCVD.
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Sohn et al. (2024) studied this question. Cilostazol effectively reduced adverse cardiovascular events in patients with prior coronary artery disease or stroke, enhancing ambulatory capacity in peripheral arterial disease.
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