Cilostazol Inhibits Leukocyte Integrin Mac-1,Leading to a Potential Reduction in Restenosis After Coronary Stent Implantation

Abstract

The study was conducted to determine if ci'ostazol inhibits leukocyte MVac-i, leading to prevention of poststent restenosis. C lostazol inhibits platelet phosphodiesterase III as well as u-granule release of P-selection in platelets, which have a key role in the upregulation of leucocyte Mac1. The activation and upregulation of NMac-i .s key in the mechanism of restenosis after coronary stenting. Consecutive patients (n = 70) undergoing coronary stenting were randomly assigned to either cilostazol or ticlopidine before stent placement. The 34 patients in the cilostazol group had a lower rate of restenosis than tne 22 patients in the ticlopidire group. Cilostazol suppressed stent-induced increases .n platelet. P selection expression and an increase in neutrophil Mac-I expression. The authors concluded that cilostazol may reduce the rate of restenosis after coronary stent implantation.

Keywords

stent restenosis cilostazol platelets

Get full access to this article

View all access options for this article.

References

1. Farb A , Burke AP , Kolodgie FD , et al: Pathological mechanisms of fatal late coronary stent thrombosis in humans. Circulation 108:1701-1706, 2003.

2. Welt FG , Rogers C : Inflammation and restenosis in the stent era. Arterioscler Thromb Vasc Biol 22:1769-1776, 2002.

3. Lau K , Mak K , Hung J , et al: Structural nuances in stent design, composition and coating may have a structural influence on the degree of arterial wall reaction. Am Heart J 147:764-773, 2004.

4. Sumpio BE . Atherosclerosis: biological and surgical considerations. In Ascher E , Hollier L , Strandness DE , editors: Haimovici's Vascular Surgery, 5th edition. Malden, MA: Blackwell Science, Inc; pp 137-163, 2004.

5. Kambayashi J , Liu Y , Sun B , et al: Cilostazol as a unique anti-thrombotic agent. Curr Pharm Des 9(28): 2289-2302, 2003.

6. Rybalkin SD , Bornfeldt KE : Cyclic nucleotide phosphodiesterases and human arterial smooth muscle cell proliferation. Thromb Haemost 82, 424-434, 1999.

7. Takahashi S , Oida K , Fujiwara R , et al: Effect of cilostazol, a cyclic AMP phosphodiesterase inhibitor, on the proliferation of rat aortic smooth muscle cells in culture. J Cardiovasc Pharmacol 20, 900-906, 1992.

8. Park SW , Lee CW , Kim HS , et al: Effects of cilostazol on angiographic restenosis after coronary stent placement. Am J Cardiol 86:499-503, 2000.

9. Sekiya MJ , Funada K , Watanabe M , et al: Effects of probucol and cilostazol alone and in combination on frequency of poststenting restenosis. Am J Cardiol 82:144-147, 1998.

10.

10. Take SM , Matsutani H , Ueda H , et al: Effect of cilostazol in preventing restenosis after percutaneous transluminal coronary angioplasty. Am J Cardiol 79:1097-1099, 1997.

11.

11. Tsuchikane E , Fukuhara A , Kobayashi T , et al: Impact of cilostazol on restenosis after percutaneous coronary balloon angioplasty. Circulation 100, 21-26, 1999.

12.

12. Yamasaki M , Hara K , Ikari Y , et al: Effects of cilostazol on late lumen loss after Palmaz-Schatz stent implantation. Cathet Cardiovasc Diagn 44, 387-391, 1998.

13.

13. Weintraub WS , Foster J , Culler SD , et al, Cilostazol for RESTenosis trial: Methods for the economic and quality of life supplement to the cilostazol for RESTenosis (CREST) trial. J Invasive Cardiol 16(5):257-259, 2004.

14.

14. Inoue T , Sohma R , Morooka S. Cilostazol inhibits the expression of activation-dependent membrane surface glycoprotein on the surface of platelets stimulated in vitro. Thromb Res 93, 137-143, 1999.