• Sang Won Han, Sung-Soo Lee, Seo Hyun Kim, Jun Hong Lee, Gyu Sik Kim, Ok-Joon Kim, Im-Seok Koh, Jong Yun Lee, Seung-Han Suk, Sung Ik Lee, Hyo Suk Nam, Won-Joo Kim, Seok Woo Yong, Kyung-Yul Lee, and Jae Hyeon Park.
• Department of Neurology at Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
• Eur. Neurol. 2013 Jan 1; 69 (1): 33-40.

BackgroundThis study is intended to evaluate the propensities of cilostazol to reduce the pulsatility index (PI) in patients with acute lacunar infarction using the serial transcranial Doppler (TCD) examinations.MethodsIn a multicenter, randomized, double-blind, placebo-controlled trial, patients were randomly assigned to receive either placebo or 100 mg cilostazol twice a day as well as aspirin 100 mg a day. The primary outcomes were the changes of middle cerebral artery (MCA) and basilar artery (BA) PIs at 14 and 90 days from the baseline TCD study. This study is registered with ClinicalTrials.gov (NCT00741286).ResultsTrial medication was given to 203 patients, with 100 receiving cilostazol and 103 receiving placebo, and 164 were included in the per-protocol analysis of the primary outcome. Results from the linear mixed model showed that significant effects were obtained for time-by-group interactions (p = 0.008 in right MCA, p = 0.015 in left MCA, p = 0.002 in BA), suggesting that changes of PIs from the baseline to the 90-day study were different across the groups.ConclusionsCilostazol further decreased TCD PIs at 90 days from baseline compared to placebo in acute lacunar infarction. This result may be related to pleiotropic effects, such as vasodilation, beyond its antiplatelet activity.Copyright © 2012 S. Karger AG, Basel.

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