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| |  Cilostazol Plus Aspirin Prevents Early Neurological Deterioration Better Than Aspirin Alone in Acute Stroke: Presented at ISC By Ed Susman SAN ANTONIO, Tex -- February 25, 2010 -- The combination of aspirin and cilostazol appears to reduce damage caused by stroke and also improves neurologic recovery faster than with aspirin alone, researchers said here at the 2010 International Stroke Conference (ISC). “Although aspirin is widely recommended as a treatment for acute ischaemic stroke, the effect of aspirin on stroke outcome is modest,” noted Tomomi Nakamura, MD, Women’s Medical University, Tokyo, Japan, during his poster presentation on February 24. “Furthermore, early neurological deterioration occasionally arises in patients with acute ischaemic stroke despite antithrombotic treatment,” he said, explaining why he and his colleagues decided to combine aspirin therapy with cilostazol. Cilostazol is approved in the United States for treatment of intermittent claudication and in Japan for secondary prevention of stroke during the chronic phase. “Cilostazol improves cerebral blood flow not only by inhibiting platelet activation but also by increasing vasodilatation, and therefore might exert favourable effects on patients with acute ischaemic stroke,” said Dr. Nakamura. The research team enrolled 76 patients undergoing acute, noncardiac embolic stroke and divided them into 2 arms: 1 group of 38 patients receiving aspirin alone, and the other 38 patients receiving aspirin and cilostazol within 24 hours after the onset of stroke symptoms. Patients receiving aspirin alone received 300 mg daily followed by 100 mg daily for at least 6 months. The other patients received the same aspirin regimen plus cilostazol 200 mg daily for at least 6 months. Of the patients receiving aspirin alone, 10 showed continuing deterioration during the first 14 days after being hospitalised compared with 2 patients in the cilostazol plus aspirin group (P = .024). Patients in the aspirin-only group had a mean age of 67 years compared with a mean age of 66 years in the cilostazol group. More than 70% of both groups were men. The National Institutes of Health Stroke Scale score was 2.8 among those on aspirin monotherapy and 3.2 on combination treatment. “Combining cilostazol with aspirin inhibits early neurological deterioration and promotes neurological improvement better than aspirin alone in patients with acute stroke,” Dr. Nakamura concluding. [Presentation title: Cilostazol Inhibits Early Neurological Deterioration in Patients With Acute Ischemic Stroke. Abstract P26]
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