Comparison of the Role of Cilostazol in the Treatment of Infarctive Stroke Patients with Those Not Receiving Cilostazol Admitted to Allied Hospital

Abstract

Background: Ischemic (infarctive) stroke has been one of the leading causes of long-term disability and mortality worldwide. Despite advancements in acute management, secondary prevention remains a crucial component of post-stroke care. Platelet aggregation plays a significant role in stroke recurrence, and antiplatelet agents such as aspirin and clopidogrel have been widely used for prevention. Cilostazol, a phosphodiesterase III inhibitor, possesses both antiplatelet and vasodilatory properties and has been shown to improve endothelial function and cerebral blood flow. However, comparative data regarding its clinical efficacy in Pakistani populations have remained limited. Therefore, this study was conducted to compare the therapeutic outcomes of infarctive stroke patients treated with cilostazol versus those who did not receive cilostazol at Allied Hospital, Faisalabad. Aim: The aim of this study was to evaluate and compare the role of cilostazol in improving neurological outcomes, reducing stroke recurrence, and enhancing functional recovery in infarctive stroke patients as compared to those not receiving cilostazol therapy. Methods and Results: This comparative observational study was conducted in the Neurology Department of Allied Hospital, Faisalabad, from February to July 2025, involving 150 patients with acute infarctive stroke. Group A (n=75) received standard stroke management plus cilostazol (100 mg twice daily), while Group B (n=75) received standard care only. Patients with hemorrhagic, cardioembolic stroke, or severe renal/hepatic disease were excluded. Outcomes were assessed using NIHSS, mRS, and BI. The cilostazol group showed greater NIHSS improvement (−5.1 vs. −3.2; p<0.01), better mRS outcomes (68% vs. 46%; p=0.02), and lower stroke recurrence (4% vs. 11%; p=0.04), with only minor side effects observed. Conclusion: The study concluded that cilostazol significantly improved neurological recovery, enhanced functional outcomes, and reduced short-term stroke recurrence among infarctive stroke patients compared to those not receiving cilostazol. Its favorable safety profile further supports its consideration as an adjunctive therapy in secondary stroke prevention. Incorporating cilostazol into standard post-stroke management protocols could lead to better rehabilitation outcomes and reduced morbidity among ischemic stroke patients.