Cilostazol vs ASA for secondary stroke prevention

This industry funded trial randomized patients with recent stroke (with 6 months) to either cilostazol (100mg bid) or ASA (81mg qday) for a mean of 29 months. The incidence of stroke was significantly lower in the cilostazol group (Hazard ratio 0.74, CI 0.56-0.98), as was the incidence of bleeding (0.77% vs 1.78%). The issue with this drug is cost, BID dosing, and side effects (headache, diarrhea, palpitations, tachycardia, and dizziness). It remains to be seen if the cost and side effect profile outweigh the benefits (reduction of stroke and bleeding) (abstract)

Danielle Scheurer

Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.

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