Progressive
stroke is a serious problem due to the associated morbidity and mortality.
Aspirin is recommended for
acute ischemic stroke, but does not reduce the frequency of
stroke progression. No standard treatment has been approved for the prevention of
stroke progression.
Cilostazol, which reduces platelet aggregation about 3 hours after single administration, does not increase the frequency of
bleeding events when compared with
aspirin or a placebo. Moreover, the combination of 100 mg
aspirin and 200 mg
cilostazol does not increase the frequency of
bleeding events compared with only 100 mg
aspirin, and thus is expected to prevent
stroke progression with a high degree of safety. The present study investigated the safety of this combination of two drugs administered at the above concentrations in 54 patients with
acute ischemic stroke within 48 hours of
stroke onset. Modified National Institutes of Health
Stroke Scale (NIHSS) measurements were performed at baseline and again on day 4 to 7. Progressive
stroke was defined as an increase greater than or equal to 1 point on NIHSS. Patient scores on the modified Rankin Scale (mRS) were evaluated at baseline and 3 months after enrollment.
Stroke progression occurred in 11.1% of the patients. The percentages of patients with mRS score from 0 to 2 were 42.6% and 75% at baseline and 3 months, respectively. No symptomatic
intracranial hemorrhage or major extracranial
hemorrhage occurred. These results suggest that administration of
aspirin and
cilostazol is safe for
acute ischemic stroke.