title: The effect of cilostazol on carotid intima-media thickness progression in patients with symptomatic intracranial atherosclerotic stenosis.
abstract: BACKGROUND
  The progression of carotid intima-media thickness (CIMT) is closely associated with ischemic stroke recurrence. However, the efficacy of cilostazol on preventing CIMT progression in stroke patients has never been investigated properly by a prospective trial.
  
  
  METHODS
  This study is a part of "Trial of Cilostazol in Symptomatic Intracranial Arterial Stenosis-2." Six centers that are available to measure CIMT according to the protocol participated in this substudy. After 7 months of randomization, the changes of CIMT were compared between cilostazol group and clopidogrel group. CIMT was measured by a semiautomated software (Intimascope) and was presented as the mean of maximum (CIMT-max) and average (CIMT-ave) of both common carotid arteries. Linear logistic regression analysis and analysis of covariance were performed to verify the independent factors associated with CIMT progression.
  
  
  RESULTS
  Among the 85 patients, 39 subjects were assigned to cilostazol group and 46 subjects to clopidogrel group. Follow-up CIMT significantly decreased in cilostazol group (CIMT-max: -.03 ± .11 and CIMT-ave: -.02 ± .08) compared with the increase in clopidogrel group (CIMT-max: .04 ± .20 and CIMT-ave: .04 ± .11; P = .05 and P = .04, respectively). Female, diabetes, and smoking were independently associated with the progression of CIMT, whereas the use of cilostazol was against CIMT progression from the results of linear regression analysis (P = .03 for both CIMT-max and CIMT-ave). The use of cilostazol also well predicted less progression of CIMT at follow-up after adjusting for baseline CIMT values and conventional risk factors (CIMT-max: P = .04 and CIMT-ave: P = .03).
  
  
  CONCLUSIONS
  Cilostazol has a beneficial effect in preventing the progression of CIMT in ischemic stroke patients.
authors: Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors: Bum Joon
authors: BJ
authors: Kim
authors: Department of Neurology, Inha University Hospital, Incheon, Korea.
authors: Joung-Ho
authors: JH
authors: Rha
authors: Department of Neurology, Inha University Hospital, Incheon, Korea.
authors: Seong Rae
authors: SR
authors: Kim
authors: Department of Neurology, Dong-guk University Hospital, Ilsan, Korea.
authors: Dong-Eog
authors: DE
authors: Kim
authors: Department of Neurology, Keon-guk University Hospital, Seoul, Korea.
authors: Hahn Young
authors: HY
authors: Kim
authors: Department of Neurology, Kangdong Sacred Heart Hospital, Seoul, Korea.
authors: Ju-Hun
authors: JH
authors: Lee
authors: Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Hee-Joon
authors: HJ
authors: Bae
authors: Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Moon-Ku
authors: MK
authors: Han
authors: Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors: Dong-Wha
authors: DW
authors: Kang
authors: Division of Neurology, Department of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors: Disya
authors: D
authors: Ratanakorn
authors: Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors: Jong S
authors: JS
authors: Kim
authors: Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Korea. Electronic address: sukwon@amc.seoul.kr.
authors: Sun U
authors: SU
authors: Kwon
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000187:drug effects*; D059168:Carotid Intima-Media Thickness; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000077407:Cilostazol; D000077144:Clopidogrel; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D013777:Tetrazoles / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine
keywords: Intracranial arterial stenosis; antiplatelets; atherosclerosis; intima–media thickness