This article examines a multicenter double-blind placebo-controlled trial of cilostazol in preventing and reducing the risk of strokes. The results showed that cilostazol improved symptomatic regression by 2% in MRA scans and 4% in TCD tests. The effectiveness of cilostazol as a prevention for ischemic strokes was also compared against aspirin and reducing alcohol consumption.

A background on ischemic strokes

Ischemic strokes account for around 80% of all strokes, making them the most common type 1. The brain has a network of blood vessels that supply it with the oxygen and nutrients, importantly glucose, which it needs to work efficiently, as well as to remove waste such as carbon dioxide. A stroke is ischemic when the artery supplying …show more content…
It acts as a phosphodiesterase 3 inhibitor, meaning that it inhibits the action of phosphodiesterase enzymes, therefore allowing red blood cells to bend more easily 7. This will allow the blood to flow more easily through the narrowed lumen in the arteries, preventing the blood supply from being as restricted so brain cells will still be supplied with essential nutrients and oxygen. It also has vasodilating effects, widening the arteries, which also helps to prevent blood constriction. These effects should reduce the risk of an ischemic stroke as it helps the blood to continue to flow so the neurons still get a sufficient blood supply to respire and remove waste.

The American Heart Association published a study in March 2005, which tested the use of cilostazol to prevent the development of atheromas in the brain. The study was a multicenter, double-blind, placebo-controlled trial and it used patients who were 35-80 years old, had had an ischemic stroke within 2 weeks of the start of the trial, with the plaque, known as a stenosis, causing blockage in the …show more content…
A patient suffering from a symptomatic stenosis is experiencing symptoms from the plaque forming in arteries in the brain; whereas a patient with a asymptomatic stenosis is suffering no symptoms. It can be seen from the MRA, that the cilostazol was effective in preventing the progression of the symptomatic stenosis as it had a 2% higher regression and 12% lower progression. This means that more patients’ stenosis improved by 1 grade or more, and fewer worsened by one grade or more due to taking the cilostazol. The TCD test also showed that cilostazol was effective as there were 4% more regressions and 12% fewer progressions, meaning again that the arteries in patients were improved by the cilostazol and, in addition, fewer patients’ arteries worsened. The MRA for asymptomatic stenosis results reinforced this again as there were 3% fewer progressions. However, it found that there were also 3% fewer regressions compared to the placebo, suggesting that cilostazol may not be effective in every case. Overall, the results indicate that, compared to the control group who took the placebo, the cilostazol was effective at preventing progression of a stenosis in a patient, leading to fewer progressions of the stenosis and more regressions, and reducing the risk for the patient suffering from an ischemic