Cilostazol--a forgotten antiplatelet agent, but does it even matter?

Cilostazol is a phosphodiesterase III inhibitor that has antiplatelet effects due to subsequent increases in cyclic adenosine monophosphate within platelets (1). This agent also provides vasodilation, improves endothelial function, inhibits vascular smooth muscle cell growth, inhibits neointimal hyperplasia, and seems to reduce the risk of restenosis and major adverse cardiac events (MACE) after percutaneous coronary interventions (PCI), without significantly increasing major hemorrhagic events, and has potential cardiovascular protection in patients with acute myocardial infarction (MI) and acute coronary syndromes (ACS) (1–4).