Effects of cilostazol: A Synthesis of Findings from 7 Studies

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Original Abstract of the Article

Main Research Findings

Cilostazol, a phosphodiesterase 3 inhibitor, has a variety of effects besides its antiplatelet activity. 4 examined the efficacy of cilostazol for the treatment of acute perforating artery infarction. The study found no significant difference in the proportion of favorable outcomes 30 days after randomization between the cilostazol group and the control group. 5 compared dual (DAT, aspirin and clopidogrel) versus triple antiplatelet therapy (TAT, DAT plus cilostazol) in patients receiving intracoronary drug-eluting stents (DES). The study found that the 24-hour heart rate (24h-HR) was significantly higher in the TAT group compared to the DAT group at six months after DES implantation. The use of cilostazol and a baseline 24h-HR ＜70 bpm were strong predictors of a 24h-HR increase ≥5 bpm. 1 demonstrated that cilostazol is effective for the treatment of intermittent claudication. The study found that cilostazol significantly increased walking distances and improved quality of life compared with placebo. 6 reviewed the antithrombotic and cardiovascular actions of cilostazol and its clinical applications. Cilostazol has vasodilating and antiplatelet properties and is useful for treating intermittent claudication in patients with peripheral artery disease (PAD). 3 performed a meta-analysis of randomized clinical trials of cilostazol for the prevention of cerebrovascular events in patients with atherothrombotic diseases. The study found that cilostazol reduced the incidence of cerebrovascular, cardiac, and vascular events. 2 examined the effects of cilostazol on lipid and fatty acid metabolism. The study found that cilostazol significantly increased walking distances and improved quality of life compared with placebo. 7 investigated the efficacy and safety of cilostazol for atherosclerosis. The study found that cilostazol treatment significantly reduced carotid intima-media thickness. Cilostazol therapy significantly increased the risk of adverse events of headache.

Benefits and Risks

Benefit Summary

Cilostazol has been shown to be effective for improving intermittent claudication in patients with peripheral artery disease (PAD). 1 Cilostazol also appears to have beneficial effects on serum lipid profile and fatty acid composition in plasma. 2 Cilostazol also has potent antiatherosclerotic effects and can reverse atherosclerosis progress even in high-risk patients. 7

Risk Summary

Cilostazol appears to result in an increase in the 24h-HR after DES implantation. 5 Cilostazol therapy significantly increased the risk of adverse events of headache. 7

Comparison of Studies

Commonalities

Cilostazol has a variety of effects besides its antiplatelet activity. 4 Cilostazol has been shown to be effective in treating intermittent claudication. 1 Cilostazol has potent antiatherosclerotic effects. 7

Differences

The effectiveness of cilostazol for the treatment of acute ischemic stroke in the lenticulostriate artery territory has been inconsistent between studies. 4 Cilostazol's effect on heart rate has also varied between studies. 5

Consistency and Contradictions of Results

While cilostazol has been shown to be effective in treating intermittent claudication and has potent antiatherosclerotic effects, there is some inconsistency in the results of studies examining cilostazol's effectiveness for the treatment of acute ischemic stroke and its effects on heart rate. 4 5 This may be due to differences in study design, patient populations, or other factors. Further research is needed to better understand the effects of cilostazol in these areas.

Considerations for Real-World Application

Cilostazol appears to be effective for improving intermittent claudication and may have beneficial effects on lipid and fatty acid metabolism. 1 2 However, cilostazol can increase heart rate and can cause headache. 5 7 Cilostazol should be taken under the guidance of a physician, especially for patients with tachycardia. 5

Limitations of Current Research

There is a need for more research on cilostazol. 4 5 Especially, the effectiveness of cilostazol for the treatment of acute ischemic stroke and its effects on heart rate requires further investigation. 4 5

Future Research Directions

To better understand the effects of cilostazol, more large-scale clinical trials are needed. 4 5 The effectiveness of cilostazol for the treatment of acute ischemic stroke and its effects on heart rate require further investigation. 4 5

Conclusion

Cilostazol has a variety of effects besides its antiplatelet activity. 4 5 1 6 3 2 7 Cilostazol appears to be effective for improving intermittent claudication and may have beneficial effects on lipid and fatty acid metabolism. 1 2 Cilostazol can increase heart rate and can cause headache. 5 7 More research is needed to better understand the effects of cilostazol. 4 5 It is important to take cilostazol under the guidance of a physician, especially for patients with tachycardia. 5

Literature analysis of 7 papers
Positive Content
5
Neutral Content
1
Negative Content
1
Article Type
3
3
2
2
7
1.

Cilostazol: a review of its use in intermittent claudication.

Author: ChapmanTherese M, GoaKaren L

Intermittent claudication treatment
Quality of life improvement
Abnormal stools
Diarrhea
Drug interactions
Headache
Infection
Palpitations
Peripheral edema
Rhinitis

Cilostazol is a medication used to treat intermittent claudication. It is generally well tolerated, but may interact with other medications that inhibit cytochrome P450 3A4 or 2C19.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

2.

Effects of cilostazol on lipid and fatty acid metabolism.

Author: NakamuraN, OsawaH, YamabeH, OkumuraK, HamazakiT

Improved fatty acid composition
Improved serum lipid profile
Increased walking distances

Cilostazol is a selective inhibitor of phosphodiesterase III with anti-platelet-aggregatory and vasodilating properties. It significantly increased walking distances in patients with intermittent claudication compared with placebo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Stroke prevention by cilostazol in patients with atherothrombosis: meta-analysis of placebo-controlled randomized trials.

Author: UchiyamaShinichiro, DemaerschalkBart M, GotoShinya, ShinoharaYukito, GotohFumio, StoneWilliam M, MoneySamuel R, KwonSun Uck

Cerebrovascular event prevention
Hemorrhagic events

Cilostazol is an antiplatelet agent that inhibits phosphodiesterase III in platelets and vascular endothelium. It has been studied for the prevention of cerebrovascular events, but the results have been mixed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Effect of cilostazol in the treatment of acute ischemic stroke in the lenticulostriate artery territory.

Author: KondoRyushi, MatsumotoYasushi, FuruiEisuke, ItabashiRyo, SatoShoichiro, YazawaYukako, ShimizuHiroaki, FujiwaraSatoru, TakahashiAkira, TominagaTeiji

Cilostazol efficacy
Perforating artery infarction

This prospective, randomized, open-label, blinded-end point trial examined the efficacy of cilostazol for the treatment of acute perforating artery infarction. Cilostazol did not prevent neurological deterioration.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

A randomized comparison study assessing the impact of cilostazol on the heart rate and arrhythmias by 24-hour ambulatory holter electrocardiographic monitoring after drug-eluting stent implantation for coronary artery disease.

Author: KwonBeom-June, LeeSu-Hyun, KimDong-Bin, ParkHun-Jun, JangSung-Won, IhmSang-Hyun, KimHee-Yeol, SeungKi-Bae

Increased heart rate

Cilostazol, when added to dual antiplatelet therapy, was found to increase heart rate in patients who received intracoronary drug-eluting stents. This effect was observed as early as six months after the stent implantation.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

Update on Cilostazol: A Critical Review of Its Antithrombotic and Cardiovascular Actions and Its Clinical Applications.

Author: ManolisAntonis A, ManolisTheodora A, MelitaHelen, MikhailidisDimitri P, ManolisAntonis S

Antiplatelet effect
Improved claudication
Reduced bleeding
Reduced restenosis
Stroke prevention
Vasodilation

Cilostazol, a phosphodiesterase III inhibitor, has vasodilating and antiplatelet properties with a low rate of bleeding complications. The study reviews the accumulated evidence of cilostazol's benefits for treating both coronary artery disease and peripheral artery disease (PAD), including its potential use after ischemic stroke.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

7.

Efficacy and Safety of Cilostazol for Atherosclerosis: A Meta-analysis of Randomized Controlled Trials.

Author: WanHongbing, HuangTieqiu, YangPingping, WuTao, ZhangHongzhou, WuQinghua

Atherosclerosis treatment
Improved lipid profile
Reduced carotid intima-media thickness
Headache

This meta-analysis of 10 randomized clinical trials found that cilostazol significantly reduced carotid intima-media thickness and had antiatherosclerotic effects without increasing the risk of bleeding.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

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