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Effect of Cilostazol in Acute Lacunar Infarction Based on Pulsatility Index of Transcranial Doppler (ECLIPse): A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

 Han SW  ;  Lee SS  ;  Kim SH  ;  Lee JH  ;  Kim GS  ;  Kim OJ  ;  Koh IS  ;  Lee JY  ;  Suk SH  ;  Lee SI  ;  Nam HS  ;  Kim WJ  ;  Yong SW  ;  Lee KY  ;  Park JH 
 EUROPEAN NEUROLOGY, Vol.69(1) : 33-40, 2013 
Journal Title
Issue Date
Aged ; Aspirin/therapeutic use* ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Humans ; Male ; Middle Aged ; Phosphodiesterase Inhibitors/therapeutic use* ; Platelet Aggregation Inhibitors/therapeutic use* ; Pulse Wave Analysis ; Stroke, Lacunar/diagnostic imaging ; Stroke, Lacunar/drug therapy* ; Tetrazoles/therapeutic use* ; Treatment Outcome ; Ultrasonography, Doppler, Transcranial
Antiplatelet activity ; Lacunar infarcts ; Transcranial Doppler ; Pulsatility index ; Cilostazol
BACKGROUND: This 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. METHODS: In 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). RESULTS: Trial 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. CONCLUSIONS: Cilostazol 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.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Joo(김원주) ORCID logo https://orcid.org/0000-0002-5850-010X
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Lee, Kyung Yul(이경열) ORCID logo https://orcid.org/0000-0001-5585-7739
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