VEGFA and endothelial dysfunction: In relation to its antiproliferative actions, cilostazol downregulates (via cAMP elevation and PKA activation) several endothelial adhesion molecules, such as the vascular cell adhesion molecule (VCAM), the intercellular adhesion molecule (ICAM) and E-selectin, as well as modulates growth factors [e.g. platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and nitric oxide] [8] Of note, cilostazol upregulates eNOS activity (thus, improving endothelial dysfunction) through multiple pathways, including activation of PKA and kinase Akt [8].