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Aspirin is only moderately effective in the prevention of ischemic stroke, yet it is the most widely used antiplatelet therapy. Although a recent meta-analysis suggests that aspirin plus extended-release dipyridamole is slightly more effective than aspirin alone, the combination is more likely to cause headache; thus, the search for safer and more effective treatment options continues. The platelet aggregation inhibitor cilostazol blocks phosphodiesterase type 3, production of thromboxane B2, and release of platelet-derived growth factor.
In a double-blind trial partially funded by the manufacturer of cilostazol, investigators in China randomized 720 patients (mean age, 60 years; 30% women) who had had an ischemic stroke within the previous …