Cilostazol-combo antiplatelet therapy reduced risk for recurrent stroke

February 06, 2019

HONOLULU, Feb. 6, 2019 -- Stroke survivors taking a combination of the blood thinner cilostazol with aspirin or clopidogrel had a lower risk of ischemic stroke recurrence than those who received aspirin or clopidogrel alone, according to late breaking science presented at the American Stroke Association's International Stroke Conference 2019, a world premier meeting for researchers and clinicians dedicated to the science and treatment of cerebrovascular disease.

Although aspirin and clopidogrel have been shown to reduce early recurrence of ischemic stroke, the benefits seem to be short and was offset by a risk of major bleeding in long-term usage, said lead author Kazunori Toyoda, M.D., Ph.D., Deputy Director General of the Hospital, National Cerebral and Cardiovascular Center in Suita, Osaka, Japan.

Since cilostazol has been shown to prevent stroke recurrence without increasing serious bleeding as compared to aspirin, researchers studied if dual antiplatelet therapy involving cilostazol would be safe and fit for long-term usage.

In a multicenter open-label, parallel-group trial, called The Cilostazol Stroke Prevention Study for Antiplatelet Combination (CSPS.com), high-risk patients were randomly assigned to receive aspirin or clopidogrel alone, or a combination of cilostazol with aspirin or clopidogrel at 292 sites in Japan over about four years. The study included 1,839 patients, including 756 taking aspirin and 1,083 taking clopidogrel. They had suffered an ischemic stroke up to six months earlier.

Researchers found:

The risk of a recurrence of ischemic stroke in high-risk patients was less common with long-term dual medication with cilostazol plus aspirin or clopidogrel compared to long-term therapy with aspirin or clopidogrel alone.

Both approaches had a similar risk of major bleeding.

The study was funded by Otsuka Pharmaceutical Co. Ltd.

Note: Scientific presentation is 11:47 a.m. Hawaii Time/4:47 p.m. Eastern Time, Wednesday, Feb. 6, 2019.
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Additional Resources:

VIDEO: Miguel Perez-Pinzon, Ph.D., FAHA, Chair, International Stroke Conference 2019 Program Committee, offers overviews and perspective on late breaking science via downloadable Skype video (transcript provided) available on the right column of the release link https://newsroom.heart.org/news/cilostazol-combo-antiplatelet-therapy-reduced-risk-for-recurrent-stroke?preview=9b0f37e8331b1bb5a86a99f011f3d4cb

Life After Stroke  

For more news from AHA International Stroke Conference 2019, follow us on Twitter @HeartNews  #ISC19. Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Stroke Association


The American Stroke Association is devoted to saving people from stroke -- the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit StrokeAssociation.org. Follow us on Facebook and Twitter.

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