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Antithrombotic treatment after stroke due to intracerebral haemorrhage
CONCLUSIONS: We did not identify beneficial or hazardous effects of short-term prophylactic dose parenteral anticoagulation and long-term oral antiplatelet therapy after ICH on important outcomes. Although there was a significant reduction in MACE and all major occlusive vascular events after long-term treatment with therapeutic dose oral anticoagulation for atrial fibrillation after ICH, the pooled estimates were imprecise, the certainty of evidence was only moderate, and effects on other important outcomes were uncertain. Large RCTs with a low risk of bias are required to resolve the ongoing dilemmas about antithrombotic...
Source: Cochrane Database of Systematic Reviews - January 26, 2023 Category: General Medicine Authors: Alexia Cochrane Chen Chen Jacqueline Stephen Ole Morten R ønning Craig S Anderson Graeme J Hankey Rustam Al-Shahi Salman Source Type: research

Evolving Approaches to Antithrombotics in Stroke Prevention and Treatment.
Authors: Javalkar V, Kuybu O, Amireh A, Kelley RE Abstract The optimization of antithrombotic therapy for acute stroke treatment and secondary prevention is an evolving process based on an increasing array of studies that provide an evidence-based approach. Options have increased dramatically with the release of the non-vitamin K oral anticoagulants and with the results of recent randomized clinical trials designed to assess potential benefits versus risks for patients in an individualized fashion. Recent studies have provided important information to guide choice and dosing of antiplatelet agents as well as the le...
Source: Southern Medical Journal - November 5, 2020 Category: General Medicine Tags: South Med J Source Type: research

Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people with antiphospholipid syndrome.
CONCLUSIONS: The evidence identified indicates that NOACs compared with standard-dose VKAs may increase the risk of stroke and do not appear to alter the risk of other outcomes (moderate-certainty evidence). Using high-dose VKA versus standard-dose VKA did not alter the risk of any thromboembolic event or major bleeding but may increase the risk of any form of bleeding (low-certainty evidence). Standard-dose VKA combined with an AP agent compared with standard-dose VKA alone may increase the risk of any thromboembolic event and does not appear to alter the risk of major bleeding or other outcomes (low-certainty evidence). ...
Source: Cochrane Database of Systematic Reviews - October 12, 2020 Category: General Medicine Authors: Bala MM, Celinska-Lowenhoff M, Szot W, Padjas A, Kaczmarczyk M, Swierz MJ, Undas A Tags: Cochrane Database Syst Rev Source Type: research

Blood Thinning Drug May Be Safer Option Against Recurrent Stroke
THURSDAY, Feb. 7, 2019 -- Taking the blood thinner Pletal (cilostazol) with either aspirin or clopidogrel (best known as Plavix) lowers stroke patients ' risk of a subsequent stroke better than taking aspirin or clopidogrel alone, a new study...
Source: Drugs.com - Daily MedNews - February 7, 2019 Category: General Medicine Source Type: news

An oral formulation of cilostazol nanoparticles enhances intestinal drug absorption in rats.
Authors: Yoshioka C, Ito Y, Nagai N Abstract Cilostazol (CLZ) is an anti-platelet agent that is generally used after the onset of cerebral infarction. However, CLZ is a poorly water-soluble drug and a strategy for increasing its bioavailability is required. In the present study, novel oral formulations were designed containing CLZ solid nanoparticles to improve bioavailability. The present study investigated the therapeutic effect of the oral formulations containing CLZ nanoparticles on ischemic stroke using a cerebral ischemia/reperfusion-induced injury model (MCAO/reperfusion mice). The oral formulation containin...
Source: Experimental and Therapeutic Medicine - January 30, 2018 Category: General Medicine Tags: Exp Ther Med Source Type: research

Antiplatelet regimens in the long-term secondary prevention of transient ischaemic attack and ischaemic stroke: an updated network meta-analysis
Conclusions Cilostazol was significantly more effective than aspirin and clopidogrel alone in the long-term prevention of serious vascular events in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Cilostazol was associated with a significantly lower bleeding risk than low-dose aspirin (75–162 mg daily) and aspirin (50 mg daily) plus dipyridamole (400 mg daily). Low-dose aspirin was as effective as higher daily doses. However, further large, randomised, controlled, head-to-head trials are needed, especially in non-Asian ethnic groups.
Source: BMJ Open - March 17, 2016 Category: Journals (General) Authors: Niu, P.-P., Guo, Z.-N., Jin, H., Xing, Y.-Q., Yang, Y. Tags: Open access, Evidence based practice, Neurology, Pharmacology and therapeutics Research Source Type: research

The Changes in Mean Platelet Volume after Using of Antiplatelet Drugs in Acute Ischemic Stroke: A Randomized Controlled Trial.
CONCLUSION: Every type of antiplatelets included in this study reduced MPV NIHSS, and mRS in acute non-cardioembolic stroke patients. Clopidogrel improved NIHSS the most. PMID: 26591394 [PubMed - indexed for MEDLINE]
Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet - December 20, 2015 Category: Journals (General) Tags: J Med Assoc Thai Source Type: research

Hemichorea in a diabetes mellitus patient following acute ischemic stroke with changes in regional cerebral blood flow
Publication date: Available online 4 March 2015 Source:Journal of the Chinese Medical Association Author(s): Yutaka Suzuki , Minoru Oishi , Akira Kanno , Katsuhiko Ogawa , Mariko Fujisawa , Satoshi Kamei It is not unusual to observe hemichorea in patients with diabetes mellitus, with origins attributable to recent ischemia. Our patient was a 66-year-old female with diabetes mellitus who suddenly developed right hemichorea, mild muscle weakness of the right upper extremity, ideational apraxia, and acalculia. Her blood glucose was 600 mg/dL, and HbA1c was 13.3%. After the patient underwent head magnetic resonance imaging ...
Source: Journal of the Chinese Medical Association - March 4, 2015 Category: Journals (General) Source Type: research

Cilostazol for intermittent claudication.
CONCLUSIONS: Cilostazol has been shown to be of benefit in improving walking distance in people with intermittent claudication secondary to PAD. Although there is an increase in adverse side effects, they are generally mild and treatable. There is currently insufficient data on whether taking cilostazol results in a reduction of all-cause mortality and cardiovascular events or an improvement in quality of life. Future research into the effect of cilostazol on intermittent claudication should carefully consider comparability, sample size and homogeneity when designing a study. PMID: 25358850 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - November 5, 2014 Category: Journals (General) Authors: Bedenis R, Stewart M, Cleanthis M, Robless P, Mikhailidis DP, Stansby G Tags: Cochrane Database Syst Rev Source Type: research