What is the efficacy of cilostazol 200 mg/d combined with other antiplatelet agents in patients with symptomatic ICAS?
Several RCTs have studied the efficacy of cilostazol 200 mg/d combined with other antiplatelet agents in patients with symptomatic ICAS. In a prespecified subgroup analysis, the risk of recurrent stroke or death at 30 days among patients with 30% intracranial stenosis ipsilateral to the ischemic event was 9.9% in the ticagrelor 90 mg twice a day plus aspirin 100 mg once a day group versus 15.2% in the aspirin 100 mg alone group (HR, 0.66 [95% CI, 0.47 0.93]; P=0.016). In contrast to the THALES patients without atherosclerosis, bleeding events among the ipsilateral atherosclerosis subgroup treated with ticagrelor and aspirin were not significantly higher than in those taking aspirin alone.