Effect of Cilostazol on Myocardial Histomorphological Changes in Ischemia-Reperfusion Injury

Introduction: Protecting the myocardium from acute ischemia-reperfusion (IR) injuries during open-heart surgeries is vital for improving outcomes. This study aimed to compare the effects of cilostazol on the nature and extent of histomorphological changes in the myocardium in a rat IR injury model.
Material and Methods: Wistar Albino rats were divided into three groups of eight. The Sham group underwent no coronary occlusion. In the IR group, the left anterior descending artery(LAD) was compressed for 45 minutes to induce acute ischemia, followed by 180 minutes of reperfusion. In the cilostazol group, 20 mg/kg/day cilostazol was administered orally for two weeks before IR induction. Rats were euthanized, and 3 mm myocardial slices were prepared for histomorphological analysis. Changes were assessed at four levels, and total, damaged, and necrotic areas were measured planimetrically. Comparisons were made using Student’s t-test, with P<0.05 considered significant.
Results: Pathohistological changes in the IR and cilostazol groups were classified as “mild” in 37.5%/53.1% (P=0.008) and “moderate” in 50.0%/43.8% (P<0.05) respectively. “Severe” changes occurred in 12.5% of IR and 3.1% of cilostazol cases (P=0.006). Ischemic and necrotic areas in the IR group (10.60±1.33 mm² and 5.76±0.62 mm²) were significantly reduced in the cilostazol group (6.94±0.73 mm² and 4.04±0.58 mm², P<<0.01).
Conclusion: Cilostazol at 20 mg/kg/day for two weeks before IR injury significantly reduced myocardial ischemic and necrotic areas, showed positive results in histopathological examination demonstrating a strong cardioprotective effect.