Y. Kim 1, J-H. Lee 2, W-G. Seo 3, S-U. Kwon 4
1 Ewha Womans University Mokdong Hospital – Seoul, Korea,
2 NHIS Ilsan Hospital – Ilsan, Korea,
3 Korea University Guro Hospital – Seoul, Korea,
4 Ulsan University Asan Medical Center – Seoul, Korea

Objective: It is reported that the occurrence of cerebral hemorrhage tends to increase in cases of accompanying lacunar infarction which occurs more frequently in Asians than in Westerners, or periventricular ischemic change which increasingly occurs with ageing. Accordingly, the point is that the occurrence of cerebral hemorrhage should be primarily considered in the treatment of cerebral infarction, along with the phenomenon of an ageing population both in Asian countries including Korea. Nevertheless, so far there has been no clinical research regarding secondary prevention of stroke, particularly considering the risk of occurrence of hemorrhage in cerebral infarction cases. However, according to a recent study, when phosphodiesterase inhibitors including cilostazol are used independently, or in combination with aspirin, secondary prevention can be improved without increasing the occurrence of hemorrhagic side effects.

Material and Methods: The primary hypothesis of this study is; cilostazol alone or with probucol will reduce the risk of cerebral hemorrhage without increase of cardiovascular events compared to aspirin in the ischemic stroke patients with symptomatic or asymptomatic old cerebral hemorrhage. Intima-Medial-Thickness (IMT) will be measured every year during follow-up period and the results will be compared with the baseline data. The change of IMT will be analyzed with the occurrence of cardiovascular events.

Results: This study is currently recruiting participants. We will present the IMT study protocol and characteristics of baseline data.

Discussion: Considering this, if it is proved that the agent, cilostazol, could decrease the risk of occurrence of stoke, along with no significant increase in the risk of occurrence of hemorrhagic side effects, by selecting a patent group with a high risk of cerebral hemorrhage, cilostazol may be recognized as an unique antiplatelet agent applicable to old-aged patient with cerebral infarction who have a certain risk of cerebral hemorrhage.

Key words: cerebral haemorrhage, cerebral infarction, intima-media thickness.

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