PDF(Pubmed)
Abstract：
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.
摘要：
动脉粥样硬化性心血管疾病（ASCVD）是全球主要的死亡原因。解决这一至关重要和普遍的情况需要多方面的方法，其中抗血小板干预起着关键作用，连同抗高血压药,抗糖尿病药,和降脂治疗。在目前可用的抗血小板药物中，西洛他唑,磷酸二酯酶-3抑制剂，提供了一系列的药理作用。这些包括血管舒张，血小板活化和聚集的障碍，血栓形成抑制，肢体血流量增加，通过甘油三酯降低和高密度脂蛋白胆固醇升高来增强血脂，抑制血管平滑肌细胞增殖。然而,在许多ASCVD指南中没有明确记录西洛他唑的作用.我们在随机临床试验中全面回顾了西洛他唑对心血管的影响，该试验将西洛他唑与对照或活性药物进行了比较，并涉及先前患有冠状动脉疾病或中风的个体。以及那些以前没有这种情况的历史的人。我们的方法表明，西洛他唑的给药有效减少不良心血管事件，尽管关于其对心肌梗死的影响的证据较少。大多数研究一致报道了其在减少间歇性跛行和增强外周动脉疾病患者的步行能力方面的有利作用。此外，西洛他唑在减轻急性冠脉综合征患者冠状动脉支架植入术后再狭窄方面显示出希望。虽然仍然需要来自更多不同地区的研究，我们的研究结果揭示了西洛他唑在动脉粥样硬化和血管生物学方面的更广泛意义，特别是对于ASCVD高危人群。
