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Cited by 66Antiplatelet Therapy and Cardiovascular DiseasesAcute Ischemic Stroke ManagementCerebrovascular and Carotid Artery Diseases

Antiplatelet Cilostazol Is Beneficial in Diabetic and/or Hypertensive Ischemic Stroke Patients

Shinohara, Yukito, Gotoh, Fumio, Tohgi, Hideo, Hirai, Shunsaku, Terashi, Akiro, Fukuuchi, Yasuo, Otomo, Eiichi, Itoh, Eiichi +5 more·2008·Cerebrovascular Diseases
DOI 10.1159/000135654
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Abstract

Background and Purpose: Although antiplatelets are known to be effective for secondary prevention of cerebral infarction, the number needed to treat is rather large and the effects in stroke patients with complications such as hypertension or diabetes are inadequately defined. This study was conducted to examine the effect of such complications on recurrence of cerebral infarction, and to assess the effect of cilostazol, an antiplatelet agent, in these high-risk subjects. Methods: A post hoc subgroup analysis of the already reported Cilostazol Stroke Prevention Study, which was a placebo-controlled double-blind trial, has been carried out to clarify the influence of various complications on recurrence in the placebo group and the effects of cilostazol in 1,095 patients with noncardioembolic ischemic cerebrovascular disease. Treatment continued for an average of 1.8 ± 1.3 years (maximum 4.8 years). Results: The recurrence rate of the diabetic stroke patients was significantly higher compared with the nondiabetics in the placebo group (9.4 vs. 4.7%/year, p = 0.01). Furthermore, our study showed that the relative risk reduction (RRR) for recurrence of infarction was 41.7% with cilostazol. This treatment provided a significant benefit in patients with lacunar infarction (RRR 43.4%, p = 0.04), with diabetes (RRR 64.4%, p = 0.008), or with hypertension (RRR 58.0%, p = 0.003). Conclusions: Diabetic patients are particularly at risk for recurrence of cerebral infarction. Cilostazol is useful for the prevention of the recurrence of vascular events in patients with lacunar infarction, and is probably effective in high-risk patients with diabetes and/or hypertension.

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Authors
Shinohara, Y., Gotoh, F., Tohgi, H., Hirai, S., Terashi, A., Fukuuchi, Y., Otomo, E., Itoh, E., Matsuda, T., Sawada, T., Yamaguchi, T., Nishimaru, K., & Ohashi, Y.
Affiliations
  • Tachikawa Hospital (JP)
  • Keio University (JP)
  • Iwate Medical University (JP)
  • Gunma University (JP)
  • Nippon Medical School (JP)
  • Ashikaga Red Cross Hospital (JP)
  • Yokufukai Hospital (JP)
  • Higashi Nagoya National Hospital (JP)
  • Kanazawa University (JP)
  • Aino Hospital (JP)
  • National Cerebral and Cardiovascular Center (JP)
  • Hayashi Eye Hospital (JP)
  • The University of Tokyo (JP)
ORCID
Venue
Cerebrovascular Diseases
Publisher
S. Karger AG
Published
2008
Volume
26
Issue
1
Pages
63-70
ISSN
  • 1015-9770 (ISSN-L)
  • 1421-9786
DOI
10.1159/000135654
OpenAlex
W2002526685
Cited by
66
References
32
Citations by year
2026: 1 · 2024: 3 · 2023: 3 · 2021: 1 · 2020: 2 · 2019: 5 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 1 · 2014: 7 · 2013: 5 · 2012: 10
FWCI
5.58
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Cerebrovascular Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
Keywords
cilostazol, antiplatelet therapy, ischemic stroke, secondary stroke prevention, diabetes mellitus, hypertension, lacunar infarction, subgroup analysis
MeSH terms
Cilostazol, Aged, Cerebral Infarction, Brain Ischemia, Double-Blind Method, Female, Humans, Hypertension, Japan, Male, Middle Aged, Platelet Aggregation Inhibitors, Risk Factors, Tetrazoles, Time Factors, Treatment Outcome, Risk Assessment, Diabetes Complications, Secondary Prevention

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