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Cilostazol also has demonstrated efficacy in patients undergoing percutaneous revascularization procedures for both PAD and coronary artery disease. In addition to its antithrombotic and vasodilating actions, cilostazol also inhibits vascular smooth muscle cell proliferation via phosphodiesterase III inhibition, thus mitigating restenosis. Accumulated evidence has shown that cilostazol, due to its \u201cpleiotropic\u201d effects, is a useful, albeit underutilized, agent for both coronary artery disease and PAD. It is also potentially useful after ischemic stroke and is an alternative in those who are allergic or intolerant to classical antithrombotic agents (eg, aspirin or clopidogrel). These issues are herein reviewed together with the pharmacology and pharmacodynamics of cilostazol. Large studies and meta\u2010analyses are presented and evaluated. Current guidelines are also discussed, and the spectrum of cilostazol's actions and therapeutic applications are illustrated.<\/jats:p>","DOI":"10.1002\/jcph.1988","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T01:43:56Z","timestamp":1634780636000},"page":"320-358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Update on Cilostazol: A Critical Review of Its Antithrombotic and Cardiovascular Actions and Its Clinical Applications"],"prefix":"10.1002","volume":"62","author":[{"given":"Antonis A.","family":"Manolis","sequence":"first","affiliation":[{"name":"Patras University School of Medicine Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodora A.","family":"Manolis","sequence":"additional","affiliation":[{"name":"Aghia Sofia Hospital Athens 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