Clinical Update Cilostazol, a Phosphodiesterase III Inhibitor: Future Prospects for Atherosclerosis

in 1988 and approved in the United States of America in 1999, for clinical treatment of intermittent claudication caused by POAD which is an important marker of systemic atherosclerosis.1 Study results demonstrate the superiority of cilostazol in comparison to placebo and pentoxifylline to increase walking distance without pain in 50 % of the patients, and the maximum walking distance in 64 % of the patients2, thus improving quality of life3. This medication is an antithrombotic antiplatelet agent4 with vasodilation action5. There is no evidence that it prolongs bleeding time when compared to acetylsalicylic acid (ASA), clopidogrel or ticlopidine6,7, or even various combinations of these drugs8. It is a potent phosphodiesterase 3 selective inhibitor, which increases 3’-5 ’ cyclic adenosine monophosphate (cAMP) in the thrombocytes and smooth muscle cells, and diminishe