TY - JOUR
T1 - Effect of oral cilostazol on acute neurological deterioration and outcome of noncardioembolic minor stroke
AU - Fujimoto, Shigeru
AU - Osaki, Masato
AU - Kanazawa, Makoto
AU - Tagawa, Naoki
AU - Kumamoto, Masaya
AU - Ohya, Yuichiro
AU - Kitazono, Takanari
N1 - Funding Information:
Takanari Kitazono received honoraria from Bayel Yakuhin Ltd. , Bristol-Myers Squibb Company , Daiichi Sankyo Company, Limited , Mitsu-bishi Tanabe Pharma Corporation , Chugai Pharmaceutical Co., Ltd. , Takeda Pharmaceutical Company, Limited , and Nippon Boehringer Ingelheim Co., Ltd. , and research support from Mitsu-bishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company, Limited, Pfizer Inc., Eisai Co., Ltd., MSD K.K., Astellas Pharma Inc., Novartis International AG., Kyowa Hakko Kirin Company, Limited, Daiichi Sankyo Company, Limited, Otsuka Pharmaceutical Co., Ltd., Nippon Boehringer Ingelheim Co., Ltd., Torii Pharmaceutical Co., Ltd., Bristol-Myers Squibb Company, Sumitomo Dainippon Pharma Co., Ltd., Sanofi S. A., and Chugai Pharmaceutical Co., Ltd.
Publisher Copyright:
© 2015, Asia Pacific League of Clinical Gerontology & Geriatrics. Published by Elsevier Taiwan LLC.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background/Purpose Stroke recurrence in the acute phase is not rare, even in minor stroke patients. We investigated whether combined antithrombotic therapy with early oral cilostazol prevents progressive stroke and improves outcomes in ischemic stroke patients. Methods For the present study, 311 first-time stroke patients who were admitted within 48 hours after the onset and were diagnosed as having a noncardioembolic stroke with National Institutes of Health Stroke Scale (NIHSS) scores of ≤ 7 were prospectively included. All patients were classified into two groups according to oral cilostazol. In Group A, 154 patients were treated with conventional antithrombotic agents with or without oral aspirin (100-200 mg/d), during the first 7 hospital days. In Group C, 157 patients were treated with oral cilostazol 200 mg/d (100 mg twice daily) plus conventional antithrombotic agents during the first 7 hospital days. Neurological deterioration during the first 21 days, stroke recurrence, cardiovascular events, and any deaths during a 3-month follow-up period were compared between Groups A and C. Results The frequencies of neurological deterioration, stroke recurrence, acute myocardial infarction, or death from all causes did not differ between Groups A and C. A good outcome at 3 months after admission was observed more frequently in Group C than in Group A patients (68% vs. 56%, p = 0.0253). In the multivariate analysis, age [odds ratio (OR), 0.94; 95% confidence interval (CI), 0.91-0.97; p < 0.0001] and initial NIHSS score (OR, 0.65; 95% CI, 0.56-0.76; p < 0.0001) were negatively associated, and cilostazol (OR, 1.99; 95% CI, 1.05-3.77; p = 0.0353) was positively associated with a good outcome. Conclusion In noncardioembolic stroke, combined antithrombotic therapy with early oral cilostazol in the acute phase appears to be associated with a good outcome in patients with progressive stroke.
AB - Background/Purpose Stroke recurrence in the acute phase is not rare, even in minor stroke patients. We investigated whether combined antithrombotic therapy with early oral cilostazol prevents progressive stroke and improves outcomes in ischemic stroke patients. Methods For the present study, 311 first-time stroke patients who were admitted within 48 hours after the onset and were diagnosed as having a noncardioembolic stroke with National Institutes of Health Stroke Scale (NIHSS) scores of ≤ 7 were prospectively included. All patients were classified into two groups according to oral cilostazol. In Group A, 154 patients were treated with conventional antithrombotic agents with or without oral aspirin (100-200 mg/d), during the first 7 hospital days. In Group C, 157 patients were treated with oral cilostazol 200 mg/d (100 mg twice daily) plus conventional antithrombotic agents during the first 7 hospital days. Neurological deterioration during the first 21 days, stroke recurrence, cardiovascular events, and any deaths during a 3-month follow-up period were compared between Groups A and C. Results The frequencies of neurological deterioration, stroke recurrence, acute myocardial infarction, or death from all causes did not differ between Groups A and C. A good outcome at 3 months after admission was observed more frequently in Group C than in Group A patients (68% vs. 56%, p = 0.0253). In the multivariate analysis, age [odds ratio (OR), 0.94; 95% confidence interval (CI), 0.91-0.97; p < 0.0001] and initial NIHSS score (OR, 0.65; 95% CI, 0.56-0.76; p < 0.0001) were negatively associated, and cilostazol (OR, 1.99; 95% CI, 1.05-3.77; p = 0.0353) was positively associated with a good outcome. Conclusion In noncardioembolic stroke, combined antithrombotic therapy with early oral cilostazol in the acute phase appears to be associated with a good outcome in patients with progressive stroke.
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U2 - 10.1016/j.jcgg.2015.09.001
DO - 10.1016/j.jcgg.2015.09.001
M3 - Article
AN - SCOPUS:84950254366
VL - 7
SP - 21
EP - 26
JO - Aging Medicine and Healthcare
JF - Aging Medicine and Healthcare
SN - 2210-8335
IS - 1
ER -