PMID- 30033486
OWN - NLM
STAT- MEDLINE
DCOM- 20200116
LR  - 20200306
IS  - 1868-601X (Electronic)
IS  - 1868-4483 (Linking)
VI  - 10
IP  - 4
DP  - 2019 Aug
TI  - Dose-Dependent Inhibitory Effects of Cilostazol on Delayed Cerebral Infarction 
      After Aneurysmal Subarachnoid Hemorrhage.
PG  - 381-388
LID - 10.1007/s12975-018-0650-y [doi]
AB  - Cilostazol is a selective inhibitor of phosphodiesterase type III that 
      downregulates tenascin-C (TNC), a matricellular protein, which may cause delayed 
      cerebral infarction after aneurysmal subarachnoid hemorrhage (SAH). The authors 
      increased the dosage and evaluated the dose-dependent effects of cilostazol on 
      delayed cerebral infarction and outcomes in SAH patients. This was a 
      retrospective cohort study in a single center. One hundred fifty-six consecutive 
      SAH patients including 67 patients of admission World Federation of Neurological 
      Surgeons grades IV-V who underwent aneurysmal obliteration within 48 h post-SAH 
      from 2007 to 2017 were analyzed. Cilostazol (0 to 300 mg/day) was administered 
      from 1-day post-clipping or post-coiling to day 14 or later. Cilostazol treatment 
      dose-dependently decreased delayed cerebral infarction and tended to improve 
      outcomes, although cilostazol did not affect other outcome measures including 
      angiographic vasospasm. On multivariate analyses, 300 mg/day (100 mg three times) 
      cilostazol independently decreased delayed cerebral infarction and improved 
      3-month outcomes, but other regimens including 200 mg/day (100 mg twice) 
      cilostazol were not independent prognostic factors. Propensity score-matched 
      analyses showed that the 300 mg/day cilostazol cohort had lower plasma TNC levels 
      and a lower incidence of delayed cerebral infarction associated with better 
      outcomes compared with the non-cilostazol cohort. The 300 mg/day cilostazol may 
      improve post-SAH outcomes by reducing plasma TNC levels and delayed cerebral 
      infarction, but not vasospasm. Further studies are warranted to investigate if 
      300 mg/day cilostazol is more beneficial to post-SAH outcomes than a usual dose 
      of 200 mg/day cilostazol that was demonstrated to be effective in randomized 
      controlled trials.
FAU - Suzuki, Hidenori
AU  - Suzuki H
AUID- ORCID: 0000-0002-8555-5448
AD  - Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 
      Edobashi, Tsu, Mie, 514-8507, Japan. suzuki02@clin.medic.mie-u.ac.jp.
FAU - Nakatsuka, Yoshinari
AU  - Nakatsuka Y
AD  - Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 
      Edobashi, Tsu, Mie, 514-8507, Japan.
FAU - Yasuda, Ryuta
AU  - Yasuda R
AD  - Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 
      Edobashi, Tsu, Mie, 514-8507, Japan.
FAU - Shiba, Masato
AU  - Shiba M
AD  - Center for Vessels and Heart, Mie University Hospital, Tsu, Japan.
FAU - Miura, Yoichi
AU  - Miura Y
AD  - Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 
      Edobashi, Tsu, Mie, 514-8507, Japan.
FAU - Terashima, Mio
AU  - Terashima M
AD  - Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 
      Edobashi, Tsu, Mie, 514-8507, Japan.
FAU - Suzuki, Yume
AU  - Suzuki Y
AD  - Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 
      Edobashi, Tsu, Mie, 514-8507, Japan.
FAU - Hakozaki, Koichi
AU  - Hakozaki K
AD  - Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 
      Edobashi, Tsu, Mie, 514-8507, Japan.
FAU - Goto, Fuki
AU  - Goto F
AD  - Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 
      Edobashi, Tsu, Mie, 514-8507, Japan.
FAU - Toma, Naoki
AU  - Toma N
AD  - Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 
      Edobashi, Tsu, Mie, 514-8507, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180723
PL  - United States
TA  - Transl Stroke Res
JT  - Translational stroke research
JID - 101517297
RN  - 0 (Phosphodiesterase 3 Inhibitors)
RN  - N7Z035406B (Cilostazol)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cerebral Infarction/*diagnostic imaging/*drug therapy/etiology
MH  - Cilostazol/*therapeutic use
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Phosphodiesterase 3 Inhibitors/*therapeutic use
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Subarachnoid Hemorrhage/complications/*diagnostic imaging/*drug therapy
MH  - Time Factors
OTO - NOTNLM
OT  - Cerebral infarction
OT  - Cerebral vasospasm
OT  - Cilostazol
OT  - Delayed cerebral ischemia
OT  - Subarachnoid hemorrhage
OT  - Tenascin-C
EDAT- 2018/07/24 06:00
MHDA- 2020/01/17 06:00
CRDT- 2018/07/24 06:00
PHST- 2018/05/15 00:00 [received]
PHST- 2018/07/16 00:00 [accepted]
PHST- 2018/06/24 00:00 [revised]
PHST- 2018/07/24 06:00 [pubmed]
PHST- 2020/01/17 06:00 [medline]
PHST- 2018/07/24 06:00 [entrez]
AID - 10.1007/s12975-018-0650-y [pii]
AID - 10.1007/s12975-018-0650-y [doi]
PST - ppublish
SO  - Transl Stroke Res. 2019 Aug;10(4):381-388. doi: 10.1007/s12975-018-0650-y. Epub 
      2018 Jul 23.