title: Cilostazol for the prevention of acute progressing stroke: a multicenter, randomized controlled trial.
abstract: BACKGROUND
  Progressing stroke is one of the major determinants of outcome after acute ischemic stroke. A pilot randomized controlled trial was conducted to investigate the effect of cilostazol on progressing stroke.
  
  
  METHODS
  Adult patients with noncardioembolic ischemic stroke within 24 hours after onset were randomized to receive cilostazol 200 mg/day (cilostazol group) or no medication (control group) in addition to the optimum medical treatments (a free radical scavenger plus an antiplatelet agent or an antithrombin agent). The primary endpoints were the rate of progressing stroke, defined as aggravation of the National Institutes of Health Stroke Scale (NIHSS) score by ≥ 4 points on days 3 and/or 5 and a modified Rankin Scale score of 0 to 1 at 3 months after enrollment. Aggravation caused by systemic complications, edema, hemorrhagic infarction, or recurrent stroke was not considered as progressing stroke. This trial was registered as UMIN000001630.
  
  
  RESULTS
  A total of 510 patients were enrolled from 55 institutions in Japan between February 2009 and July 2010. The rate of progressing stroke was 3.2% and 6.3% in the cilostazol and control groups, respectively (P = .143). The modified Rankin Scale score of 0 to 1 at 3 months did not differ between the groups.
  
  
  CONCLUSIONS
  Cilostazol failed to show a preventive effect against acute progressing stroke. However, the tendency to reduce progressing stroke and the results of stratified analyses may encourage additional studies to clarify the effect of cilostazol in the treatment of acute ischemic stroke.
authors.affiliation: Department of Neurosurgery at Kohnan Hospital, Sendai, Japan. hshim@kohnan-sendai.or.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
authors.forename: Akira
authors.initials: A
authors.lastname: Ogawa
authors.forename: Takamasa
authors.initials: T
authors.lastname: Kayama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Mizoi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Saito
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Terayama
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Ogasawara
authors.forename: Etsuro
authors.initials: E
authors.lastname: Mori
mesh_terms: D000368:Aged; D000077407:Cilostazol; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy*; D013777:Tetrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D016166:Free Radical Scavengers; D018696:Neuroprotective Agents; D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077407:Cilostazol