Cilostazol Stroke Prevention Study for Antiplatelet Combination

Inclusion criteria

• Patients with a diagnosis of noncardioembolic IS that developed between 8 and 180 days before the start of the protocol treatment
• Patients with a responsible lesion identified by MRI
• Patients aged 20 to 85 years old when providing informed consent
• Patients taking clopidogrel or aspirin alone as antiplatelet therapy when providing informed consent
• Patients meeting at least one of the following criteria a-c:

• at least 50% stenosis of a major intracranial artery (to the level of A2, M2, or P2)
• at least 50% stenosis of an extracranial artery (the common carotid artery，internal carotid artery，vertebral artery，brachiocephalic artery，or subclavian artery)
• Two or more of the following risk factors

• Aged 65 years or more
• Diabetes mellitus
• Hypertension
• Peripheral arterial disease
• Chronic kidney disease
• History of IS (excluding the index IS for this study)
• History of ischemic heart disease
• Smoking (only current smokers)
• Patients considered to be able to visit the study site for ambulatory care throughout the observation period
• Patients who provided written informed consent

Exclusion criteria

• Patients with emboligenic heart disease
• Patients taking any anticoagulant agents
• Patients who cannot undergo MRI examination for reasons such as claustrophobia and implanted pacemaker
• Patients scheduled to undergo any surgery, such as percutaneous angioplasty, stent placement, and bypass grafting, during the study period
• Patients with a drug-eluting coronary stent implanted within one year
• Patients with a history of symptomatic non-traumatic intracranial hemorrhage, any other hemorrhagic disease (eg, active peptic ulcer), bleeding predisposition, or blood clotting disorders
• Patients with a history of hypersensitivity to cilostazol
• Patients with congestive heart failure or uncontrolled angina pectoris
• Patients with thrombocytopenia (platelet count ≦ 100,000/mm3)
• Patients with severe liver or renal dysfunction
• Women who are pregnant, breast-feeding, or of child-bearing potential
• Patients with a malignant tumor requiring treatment
• Patients who are taking aspirin, and meet any of the following criteria:

• History of hypersensitivity to aspirin or salicylic acid analogues
• Current peptic ulcer
• Aspirin-induced asthma or its history
• Patients who are taking clopidogrel, and meet the following criterion:

・History of hypersensitivity to clopidogrel

• Patients who are participating in any other clinical studies
• Patients considered by the investigator/subinvestigator to be unsuitable for participating in this study