Cilostazol w praktyce klinicznej Opis przypadku
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Opublikowane:
cze 30, 2025
Słowa kluczowe:
cilostazol, choroba naczyń obwodowych, chromanie przestankowe
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Abstrakt
W artykule zostały przedstawione właściwości farmakologiczne oraz kliniczne cilostazolu. Omówiono farmakologię leku, mechanizm jego działania, farmakokinetykę, zasady dawkowania, skutki uboczne oraz możliwe działania niepożądane mogące wystąpić podczas stosowania leku. Podkreślono jego przydatność w redukcji objawów choroby naczyń obwodowych na tle miażdżycy zarostowej, polegającą na wydłużeniu dystansu chromania przestankowego podczas leczenia zachowawczego choroby. Opisano dwa studia przypadków pacjentów z chorobą naczyń obwodowych, które ilustrują praktyczne zastosowanie cilostazolu w poszczególnych sytuacjach klinicznych. Podsumowując, cilostazol można określić jako cenny lek uzupełniający farmakologiczne leczenie objawów choroby naczyń obwodowych, mający udowodnione klinicznie działanie.
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Jak cytować
Glinka, M. (2025). Cilostazol w praktyce klinicznej . Medycyna Faktów , 18(2(67), 317-322. https://doi.org/10.24292/01.MF.0225.22
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Dział
Artykuły
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Bibliografia
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2. WHO. The Top 10 Causes of Death.
3. Gulledge J. Update on the pathophysiology and medical treatment of peripheral artery disease. Nat Rev Cardiol. 2022; 19: 456-74.
4. Morley RL, Sharma A, Horsch AD et al. Peripheral artery disease. BMJ. 2018; 360: 5842.
5. Steg PG, Bhatt DL, Wilson PW et al. One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA. 2007; 297: 1197-206.
6. Hussain MA, Al-Omran M, Creager MA et al. Antithrombotic therapy for peripheral artery disease: recent advances. J Am Coll Cardiol. 2018; 71: 2450-67.
7. Tanaka T, Ishikawa T, Hagiwara M et al. Effects of cilostazol, a selective cAMP phosphodiesterase inhibitor on the contraction of vascular smooth muscle. Pharmacology. 1988; 36: 313-20.
8. Bramer SL, Tata PNV, Mallikaarjun S. Disposition of 14 C-cilostazol after single dose administration to healthy human subjects. Phar Res. 1997; 14(suppl.): 612.
9. Omi H, Okayama N, Shimuzu M et al. Cilostazol inhibits high glucose-mediated endothelial-neutrophil adhesion by decreasing adhesion molecule expression via NO production. Microvasc Res. 2004; 68: 119-25.
10. Suzuki K, Uchida K, Nakanishi N et al. Cilostazol activates AMP-activated protein kinase and restores endothelial function in diabetes. Am J Hypertens. 2008; 21: 451-7.
11. Brown T, Forster RB, Cleanthis M et al. Cilostazol for intermittent claudication. Cohrane Database Syst Rev. 2021; 6: CD003748.
12. Dawson DL, Cutler BS, Hiatt WR et al. A comparison of cilostazol and pentoxifylline for treating intermittent claudication. Am J Med. 2000; 109: 523-30.
13. Strandness DE, Dalman RL, Panian S et al. Effect of cilostazol in patients with intermittent claudication: A randomized, double-blind, placebocontrolled study. Vasc Endovasc Surg. 2002; 36: 83-91.
14. De Franciscis S, Galleli L, Battaglia L et al. Cilostazol prevents foot ulcers in diabetic patients with peripheral vascular disease. Int Wound J. 2015; 12: 250-3.
15. Gerhard-Herman MD, Gornik HL, Barrett C et al. 2016 AHA/ACC Guideline on the management of patients with lower extremity peripheral artery disease: executive summary: a report of the American College of Cardiology / American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol. 2017; 118: 1465-508.
16. Soga Y, Yokoi H, Kawasaki T et al. Efficacy of cilostazol after endovascular therapy for femoropopliteal artery disease in patients with intermittent claudication. J Am Coll Cardiol. 2009; 53: 48-53.
17. Iida O, Yokoi H, Soga Y et al.; STOP-IC investigators. Cilostazol reduces angiographic restenosis after endovascular therapy for femoropopliteal lesions in the Sufficient Treatment of Peripheral Interventions by Cilostazol study. Circulation. 2013; 127: 2307-15.
18. Iida O, Nanto S, Uematsu M et al. Cilostazol reduces restenosis after endovascular therapy in patients with femoropopliteal lesions. J Vasc Surg. 2008; 48: 144-9.
19. Jeong YH, Tantry US, Park Y et al. Pharmacodynamic effect of cilostazol plus standard clopidogrel versus double-dose clopidogrel in patients with type 2 diabetes undergoing percutaneous coronary intervention. Diabetes Care. 2012; 35: 2194-7.
20. Lee SW, Park SW, Kim YH et al. A randomized, double-blind, multicenter comparison study of triple antiplatelet therapy to reduce restenosis after drug – eluting stent implantation in long coronary lesions: results from the CECLARE-LONG II (Drug-Eluting Stenting Followed by Cilostazol Treatment Reduces Late Restenosis in Patients with Long Coronary Lesions) trial. J Am Coll Cardiol. 2011; 57: 1264-70.
21. Trani A, Benedetto P, Di Leo F et al. Long term efficacy and safety of rivaroxaban plus cilostazol in the treatment of critical ischemia of the lower limbs in a frail, elderly patient with non valvular atrial fibrillation. J Pharm Health Care Sci. 2020; 6: 17.
22. Krasiński Z, Gaciong ZA, Szymański FM et al. The position of Polish experts on conservative management in patients with artery diseases of lower limbs. (Stanowisko polskich ekspertów dotyczących leczenia zachowawczego u pacjentów z chorobą tętnic kończyn dolnych). Acta Angiol. 2019; 25: 41-76.
23. Nordanstig J, Behredt C, Baumgartner I et al. European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Caludication. Eur J Vasc Endovasc Surg. 2024; 67: 9-96.
24. Mazzolai L, Teixido-Tura G, Lanzi S et al. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J. 2024; 45: 3538-700.
25. Cilostazol. Charakterystyka Produktu Leczniczego.
2. WHO. The Top 10 Causes of Death.
3. Gulledge J. Update on the pathophysiology and medical treatment of peripheral artery disease. Nat Rev Cardiol. 2022; 19: 456-74.
4. Morley RL, Sharma A, Horsch AD et al. Peripheral artery disease. BMJ. 2018; 360: 5842.
5. Steg PG, Bhatt DL, Wilson PW et al. One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA. 2007; 297: 1197-206.
6. Hussain MA, Al-Omran M, Creager MA et al. Antithrombotic therapy for peripheral artery disease: recent advances. J Am Coll Cardiol. 2018; 71: 2450-67.
7. Tanaka T, Ishikawa T, Hagiwara M et al. Effects of cilostazol, a selective cAMP phosphodiesterase inhibitor on the contraction of vascular smooth muscle. Pharmacology. 1988; 36: 313-20.
8. Bramer SL, Tata PNV, Mallikaarjun S. Disposition of 14 C-cilostazol after single dose administration to healthy human subjects. Phar Res. 1997; 14(suppl.): 612.
9. Omi H, Okayama N, Shimuzu M et al. Cilostazol inhibits high glucose-mediated endothelial-neutrophil adhesion by decreasing adhesion molecule expression via NO production. Microvasc Res. 2004; 68: 119-25.
10. Suzuki K, Uchida K, Nakanishi N et al. Cilostazol activates AMP-activated protein kinase and restores endothelial function in diabetes. Am J Hypertens. 2008; 21: 451-7.
11. Brown T, Forster RB, Cleanthis M et al. Cilostazol for intermittent claudication. Cohrane Database Syst Rev. 2021; 6: CD003748.
12. Dawson DL, Cutler BS, Hiatt WR et al. A comparison of cilostazol and pentoxifylline for treating intermittent claudication. Am J Med. 2000; 109: 523-30.
13. Strandness DE, Dalman RL, Panian S et al. Effect of cilostazol in patients with intermittent claudication: A randomized, double-blind, placebocontrolled study. Vasc Endovasc Surg. 2002; 36: 83-91.
14. De Franciscis S, Galleli L, Battaglia L et al. Cilostazol prevents foot ulcers in diabetic patients with peripheral vascular disease. Int Wound J. 2015; 12: 250-3.
15. Gerhard-Herman MD, Gornik HL, Barrett C et al. 2016 AHA/ACC Guideline on the management of patients with lower extremity peripheral artery disease: executive summary: a report of the American College of Cardiology / American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol. 2017; 118: 1465-508.
16. Soga Y, Yokoi H, Kawasaki T et al. Efficacy of cilostazol after endovascular therapy for femoropopliteal artery disease in patients with intermittent claudication. J Am Coll Cardiol. 2009; 53: 48-53.
17. Iida O, Yokoi H, Soga Y et al.; STOP-IC investigators. Cilostazol reduces angiographic restenosis after endovascular therapy for femoropopliteal lesions in the Sufficient Treatment of Peripheral Interventions by Cilostazol study. Circulation. 2013; 127: 2307-15.
18. Iida O, Nanto S, Uematsu M et al. Cilostazol reduces restenosis after endovascular therapy in patients with femoropopliteal lesions. J Vasc Surg. 2008; 48: 144-9.
19. Jeong YH, Tantry US, Park Y et al. Pharmacodynamic effect of cilostazol plus standard clopidogrel versus double-dose clopidogrel in patients with type 2 diabetes undergoing percutaneous coronary intervention. Diabetes Care. 2012; 35: 2194-7.
20. Lee SW, Park SW, Kim YH et al. A randomized, double-blind, multicenter comparison study of triple antiplatelet therapy to reduce restenosis after drug – eluting stent implantation in long coronary lesions: results from the CECLARE-LONG II (Drug-Eluting Stenting Followed by Cilostazol Treatment Reduces Late Restenosis in Patients with Long Coronary Lesions) trial. J Am Coll Cardiol. 2011; 57: 1264-70.
21. Trani A, Benedetto P, Di Leo F et al. Long term efficacy and safety of rivaroxaban plus cilostazol in the treatment of critical ischemia of the lower limbs in a frail, elderly patient with non valvular atrial fibrillation. J Pharm Health Care Sci. 2020; 6: 17.
22. Krasiński Z, Gaciong ZA, Szymański FM et al. The position of Polish experts on conservative management in patients with artery diseases of lower limbs. (Stanowisko polskich ekspertów dotyczących leczenia zachowawczego u pacjentów z chorobą tętnic kończyn dolnych). Acta Angiol. 2019; 25: 41-76.
23. Nordanstig J, Behredt C, Baumgartner I et al. European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Caludication. Eur J Vasc Endovasc Surg. 2024; 67: 9-96.
24. Mazzolai L, Teixido-Tura G, Lanzi S et al. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J. 2024; 45: 3538-700.
25. Cilostazol. Charakterystyka Produktu Leczniczego.