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Effect of Cilostazol in the Acute Lacunar Infarction Based on Pulsatility Index of Transcranial Doppler (ECLIPse)

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ClinicalTrials.gov Identifier: NCT00741286
Recruitment Status : Completed
First Posted : August 26, 2008
Results First Posted : September 5, 2011
Last Update Posted : September 5, 2011
Sponsor:
Collaborator:
Korea Otsuka Pharmaceutical Co., Ltd.
Information provided by:
Inje University

Study Description
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Brief Summary:

RATIONALE:

  • Elevation in pulsatility indices (PIs), measured by transcranial Doppler (TCD), has been postulated to reflect downstream increased vascular resistance caused by small-vessel disease (SVD).
  • Small arterial vessels are a significant determinant of vascular resistance and PIs are elevated when SVD is present in the intracranial circulation.
  • Cilostazol, a phosphodiesterase III inhibitor, has other non-antiplatelet effects, such as vasodilation and neuroprotective effect. It has been shown to be effective in the secondary prevention of stroke especially in the SVD and it may be related to the other non-antiplatelet effects of cilostazol.

OBJECTIVES:

  • In this study, we aim to investigate whether cilostazol affects the changes of PIs in patients with acute lacunar infarction using serial TCDs.
  • Our hypothesis is that cilostazol has other non-antiplatelet effects such as vasodilation effect and may decrease the vascular resistance in patients with acute lacunar infarction. Hence, cilostazol will decrease the PIs in patients with acute lacunar infarction.

Condition or disease Intervention/treatment Phase
Cerebral Infarction Drug: Aspirin Drug: cilostazol Phase 4

Detailed Description:

TREATMENTS:

  • Cilostazol is an agent inhibiting platelet aggregation.
  • A matching placebo of cilostazol is an inactive substance that looks similar to the active cilostazol tablet.

TREATMENT PLAN:

  • There will be two treatment groups; one will receive cilostazol 200mg (100mg twice per day), the second matching placebo of cilostazol.
  • These study drugs will be administered on top of aspirin (100mg) systematically prescribed to such patients

PRIMARY ENDPOINT:

  • The changes of PI between the baseline and 14 and 90 days follow-up study.

STUDY EXECUTION:

  • Two hundred sixty patients, presenting with first ever lacunar infarction within 7 days after the onset of symptoms will be recruited within two years.
  • Patients will be followed up during the three months.
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 203 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Study for the Multi-Center Placebo-Controlled Double-Blind Clinical Trial for the Evaluation of the Effect of Cilostazol on Pulsatility Index of Transcranial Doppler in the Acute Lacunar Infarction Patients
Study Start Date : November 2006
Actual Primary Completion Date : October 2008
Actual Study Completion Date : October 2008

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Placebo Comparator: Asprin (100mg) plus placebo
Asprin (100mg) plus placebo
 Drug: Aspirin
Asprin (100mg) plus placebo
Active Comparator: Asprin (100mg) plus cilostazol (200mg)
Asprin (100mg) plus cilostazol (200mg)
 Drug: cilostazol
Aspirin (100mg) plus cilostazol (200mg)
Other Name: Pletaal


Outcome Measures
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Primary Outcome Measures :
  1. The Changes of Middle Cerebral Artery (MCA) and Basilar Artery (BA) Pulsatility Index (PI) at 14 and 90 Days From the Baseline Transcranial Doppler (TCD) Study [ Time Frame: 14 days and 90 days from the baseline TCD study ]
    The PI is designed to measure vascular resistance and characterizes the shape of the spectral waveform. For the study, the mean, systolic, and diastolic flow velocities were measured using TCD. Gosling's PI was determined as the difference between the peak systolic and end-diastolic velocities divided by the mean flow velocity in each artery.The changes of MCA and BA PIs at 14 and 90 days from the baseline TCD study was calculated for the study.


Secondary Outcome Measures :
  1. Number of Patients With First Recurrent Stroke of Any Type [ Time Frame: 90 days ]

Eligibility Criteria
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Ages Eligible for Study:   45 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with first ever lacunar infarction within 7 days after the onset of symptoms
  • Age: more than 45 years of age

Exclusion Criteria:

  • Patients with any contraindications to the treatment with antiplatelet therapy
  • Patients with potential cardiac embolic source; prosthetic valve, atrial fibrillation, atrial flutter, left atrial/atrial appendage thrombus, sick sinus syndrome, left ventricular thrombus, dilated cardiomyopathy, akinetic or hypokinetic left ventricular segment, atrial myxoma, Infective endocarditis, mitral valve stenosis or prolapse, mitral annuls calcification, left atrial turbulence, nonbacterial endocarditis, congestive heart failure, recent myocardial infarction (within 4 weeks)
  • Bleeding diathesis
  • Chronic liver disease (ALT > 100 or AST > 100) or chronic renal disease (creatinine > 3.0mg/dl)
  • Anemia (hemoglobin < 10mg/dl) or thrombocytopenia (platelet count less than 100,000/mm3)
  • Nonatherosclerotic vasculopathy; patients with clinical characteristics suggesting arterial dissection, moyamoya disease, Takayasu's arteritis, radiation associated angiopathy, and other vasculitis.
  • Pregnant or lactating patients
  • Patients with hyperthyroidism or COPD
  • Patients with current anticoagulation or antiplatelet therapy
  • Patients with poor temporal window in transcranial Doppler
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00741286


Locations
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Korea, Republic of
Sanbon Medical Center
Gunpo, Korea, Republic of, 435-040
National Health Insurance Corporation Ilsan Hospital
Ilsan, Korea, Republic of, 411-719
Bundang CHA Hospital
Seongnam, Korea, Republic of, 463-712
National medical center
Seoul, Korea, Republic of, 100-799
Yongdong Severance Hospital
Seoul, Korea, Republic of, 135-720
Sanggye Paik Hospital
Seoul, Korea, Republic of, 139-707
Ajou University Hospital
Suwon, Korea, Republic of, 443-721
Wonju Christian Hospital
Wonju, Korea, Republic of, 220-701
Sponsors and Collaborators
Inje University
Korea Otsuka Pharmaceutical Co., Ltd.
Investigators
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Principal Investigator: Jae Hyeon Park, MD, PhD Sanggye Paik Hospital, Inje University College of Medicine
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Jae Hyeon Park, MD, PhD, Sanggye Paik Hospital, Inje University College of Medicine
ClinicalTrials.gov Identifier: NCT00741286    
Other Study ID Numbers: ECLIPse
First Posted: August 26, 2008    Key Record Dates
Results First Posted: September 5, 2011
Last Update Posted: September 5, 2011
Last Verified: August 2010
Keywords provided by Inje University:
Cerebral infarction
Cilostazol
Aspirin
Transcranial Doppler
Pulsatile Index
Additional relevant MeSH terms:
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Cerebral Infarction
Stroke, Lacunar
Infarction
Ischemia
Pathologic Processes
Necrosis
Brain Infarction
Brain Ischemia
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Stroke
Vascular Diseases
Cardiovascular Diseases
 Cerebral Small Vessel Diseases
Thrombotic Stroke
Ischemic Stroke
Aspirin
Cilostazol
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Analgesics
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Inflammatory Agents
Antirheumatic Agents
Fibrinolytic Agents
Fibrin Modulating Agents