Source: DGNews  |  Posted 4 years ago

By Rachel Tilley

GLASGOW, UK -- June 1, 2007 -- Cilostazol reduced cerebral haemorrhaging and had the same efficacy as aspirin in preventing recurrent stroke in patients with ischaemic disease, reported researchers at the 16[^]th[] annual European Stroke Conference (ESC).

"Chinese stroke patients have a high incidence [23%] of cerebral hemorrhage," said Dr Y.N. Huang, MD, Peking University First Hospital, Peking, China.

Dr. Huan and colleagues designed a randomised, double-blinded aspirin controlled study to determine the efficacy and long term safety of cilostazol in patients after ischaemic stroke.

For the study, 720 patients ischaemic stroke were recruited between 1 and 6 months after the onset of symptoms. Of these patients, 360 were randomised to cilostazol 200 mg twice daily and 360 to aspirin 100 mg once a day for a duration of 12 to 18 months. Nine patients were lost to follow up (3 in the aspirin group and 6 in the cilostazol group).

A lower incidence of primary events were observed in the cilostazol group (3.2%) compared with the aspirin group (5.2%). Eleven patients had a recurrent ischaemic stroke and 1 had a haemorrhage in the cilostazol group; 15 patients had recurrent stroke and 5 suffered haemorrhages.

The relative risk of primary event was reduced by 38.1%. The absolute reduction was only 2% and was not significant ([]P =.[]18).

Dr. Huang pointed out that although the efficacy of cilostazol was similar to that of aspirin for the first 200 days of the study, cilostazol showed improvements over aspirin for the remainder of the study.

Stroke patients were screened with magnetic resonance imaging at the beginning and the end of the study. Surprisingly, 33% of patients in the aspirin group showed microbleeding compared with 9% in the cilostazol group ([]P =.[]047). Dr. Huang said that 2 of the patients in the aspirin group with microbleeds had an associated haematoma.

He concluded that, "after a half a year of treatment, cilostazol may be better than aspirin especially in preventing cerebral haemorrhages and permutations." He added that, "aspirin was significantly associated with microbleeding, and screening for microbleeds may be helpful to reduce [the incidence of] cerebral haemorrhages."

[[]Presentation title: Cilostazol reduces Cerebral Hemorrhage in Secondary Stroke Prevention: A Multicenter, Randomized, Double-Blinded, Aspirin Control Study. Long Term Outcome of Stroke. Abstract 05[]]