Influence for functional outcome by different antiplatelet drugs; acetylsalicylic acid and cilostazol

  • Yamamoto Nobuaki
    Department of Neurology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Satomi Junichiro
    Department of Neurosurgery, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Terasawa Yuka
    Department of Neurology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Sogabe Shu
    Department of Neurosurgery, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Nakajima Kohei
    Department of Neurosurgery, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Sato Yasuhito
    Department of Neurosurgery, Tokushima Prefectural Central Hospital
  • Bando Kazuhiko
    Department of Neurosurgery, Anan-Kyoei Hospital
  • Agawa Masahito
    Department of Neurosurgery, Tokushima Prefectural Naruto Hospital
  • Asano Noboru
    Department of Neurosurgery, Oe-Kyodo Hospital
  • Hondo Hideki
    Department of Neurosurgery, Tokushima Prefectural Central Hospital
  • Izumi Yuishin
    Department of Neurology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Kaji Ryuji
    Department of Neurology, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Nagahiro Shinji
    Department of Neurosurgery, Institute of Health Biosciences, The University of Tokushima Graduate School

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Other Title
  • 脳梗塞発症後早期からの抗血小板薬使用が予後に及ぼす影響の検討

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Background: Previously, cilostazol (CIL) was reported as an alternative drug for acetylsalicylic acid (ASA) in cases with non cardioemboic (CE) stroke. We studied the difference of efficacy for non CE stroke patients between ASA and CIL. Especially, we evaluated the efficacy of these drugs for severity of stroke, functional outcome, and post-stroke depression.Objects and Methods: Patients with non CE stroke, who were admitted into our hospital and affiliated hospitals during April 2010 and December 2012, were objects of our study. We excluded patients who disagreed with our informed consent, already took antiplatelet drugs before onset of ischemic stroke, and had complicated atrial fibrillation. We included 168 patients, and divided these patients into two groups; group ASA and group CIL. We compared stroke severity, functional outcome and post-stroke depression using modified Rankin Scale (mRS), the National Institute of Health Stroke Scale (NIHSS) score, and Self-rating-Depression Scale (SDS) score between group ASA and group CIL. The times of assessment of the scores such as NIHSS, mRS, and SDS were at the time of admission into our hospitals and discharge from our hospitals, and 3 months after onset.Results: Baseline characteristics, NIHSS, mRS, and SDS of two groups were not significantly different. In both groups, functional outcome tended to be poor with advancing age and greater number of complications.Conclusion: The efficacy of ASA and CIL for stroke severity, functional outcome, and post-stroke depression was not significantly different in this study. Higher age and the greater number of complicated diseases were associated with poor functional outcome after ischemic stroke except for CE.

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