CSPS
(2019)Objective
Cilostazol plus aspirin or clopidogrel versus monotherapy in high-risk non-cardioembolic stroke patients.
Study Summary
• Dual antiplatelet therapy with cilostazol significantly reduced recurrent ischemic stroke compared to aspirin or clopidogrel monotherapy, without a significant increase in serious bleeding.
Intervention
Cilostazol 100 mg BID + aspirin (81–100 mg) or clopidogrel (50–75 mg) daily vs. aspirin or clopidogrel monotherapy. Median follow-up 1.4 years. Trial stopped early after enrolling 1884 of planned 4000 patients.
Study Design
Arms: Array
Outcome
• Recurrent ischemic stroke — 3% (dual) vs. 7% (mono); HR 0.49 (95% CI 0.31–0.76); p=0.0010
• Severe or life-threatening bleeding — 0.6% vs. 0.9%; HR 0.66 (95% CI 0.27–1.60); p=0.35
• Serious adverse events — 10% (dual) vs. 15% (mono)
• Any bleeding — 4% in both groups
• GI bleeding — <1% in both groups
• Severe or life-threatening bleeding — 0.6% vs. 0.9%; HR 0.66 (95% CI 0.27–1.60); p=0.35
• Serious adverse events — 10% (dual) vs. 15% (mono)
• Any bleeding — 4% in both groups
• GI bleeding — <1% in both groups