Clopidogrel Versus Cilostazol in Large-vessel Ischemic Stroke

Summary

Along with the current clinical trial, the efficacy and safety of a 300 mg loading dose of ticagrelor administered within 24 hours of the first-ever large-vessel ischemic stroke compared to 200 mg cilostazol were assessed through NIHSS, mRS, and possible adverse effects.

Timeline

Start

2023-01-01

Primary completion

2024-07-01

Completion

2024-08-01

Publications

• Results Paciaroni M, Ince B, Hu B, Jeng JS, Kutluk K, Liu L, Lou M, Parfenov V, Wong KSL, Zamani B, Paek D, Min Han J, Del Aguila M, Girotra S. Benefits and Risks of Clopidogrel vs. Aspirin Monotherapy after Recent Ischemic Stroke: A Systematic Review and Meta-Analysis. Cardiovasc Ther. 2019 Dec 1;2019:1607181. doi: 10.1155/2019/1607181. eCollection 2019.
• Results Meyer DM, Albright KC, Allison TA, Grotta JC. LOAD: a pilot study of the safety of loading of aspirin and clopidogrel in acute ischemic stroke and transient ischemic attack. J Stroke Cerebrovasc Dis. 2008 Jan-Feb;17(1):26-9. doi: 10.1016/j.jstrokecerebrovasdis.2007.09.006.
• Results Gachet C, Stierle A, Cazenave JP, Ohlmann P, Lanza F, Bouloux C, Maffrand JP. The thienopyridine PCR 4099 selectively inhibits ADP-induced platelet aggregation and fibrinogen binding without modifying the membrane glycoprotein IIb-IIIa complex in rat and in man. Biochem Pharmacol. 1990 Jul 15;40(2):229-38. doi: 10.1016/0006-2952(90)90683-c.
• Ahmed SR, Khalil MFE, Ismaiel M, Omar TY, Refat HM, Ebied AAMK, Abdelwahed N, Akl AZO, Mahmoud ELA, Ahmed SI, Hassan AM, Kamel IFM, Egila AAE, Abouelnaga M, Zeinhom MG. Cilostazole versus clopidogrel in acute large-vessel moderate and moderate-to-severe ischemic stroke: a randomized controlled trial. Neurol Sci. 2025 Aug;46(8):3973-3986. doi: 10.1007/s10072-025-08107-9. Epub 2025 Apr 15.

Drugs

Indications