Effect of cilostazol in the treatment of acute ischemic stroke in the lenticulostriate artery territory

Eur Neurol. 2013;69(2):122-8. doi: 10.1159/000343799. Epub 2012 Nov 29.

Abstract

Background: Cilostazol, an inhibitor of phosphodiesterase 3, has various pleiotropic effects besides its antiplatelet activity. This study examined the efficacy of cilostazol for the treatment of acute perforating artery infarction.

Methods: In this prospective, randomized, open-label, blinded-end point trial, 100 patients with cerebral infarction in the territory of the lenticulostriate arteries were enrolled within 48 h of onset. Patients were randomly treated with both cilostazol and ozagrel for 14 days (n = 50, cilostazol group) or ozagrel alone for 14 days (n = 50, control group). The primary end point was the proportion of favorable outcomes 30 days after randomization as defined by a modified Rankin Scale (mRS) score of 0-2. Secondary end points included the incidence of neurological deterioration (an increase of ≥ 2 on the National Institutes of Health Stroke Scale within 7 days).

Results: Favorable outcomes (mRS scores 0-2) were similar in both groups (81.3 and 82.0% in the cilostazol and control groups, respectively). The incidence of neurological deterioration was lower in the cilostazol group than the control group (12.5 and 16.0%, respectively) with a 21.9% relative risk reduction, although the difference was not statistically significant.

Conclusions: Cilostazol did not prevent the neurological deterioration of perforating artery infarction.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / drug therapy*
  • Cilostazol
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Male
  • Methacrylates / therapeutic use
  • Middle Aged
  • Stroke / drug therapy*
  • Tetrazoles / therapeutic use*
  • Time Factors
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Methacrylates
  • Tetrazoles
  • ozagrel
  • Cilostazol