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Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial

Appleton, Jason P.; Flaherty, Katie; Blair, Gordon W.; Law, Zhe Kang; Doubal, Fergus; Sprigg, Nikola; Bath, Philip M.; Wardlaw, Joanna M.

Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial Thumbnail


Authors

Jason P. Appleton

Katie Flaherty

Gordon W. Blair

Zhe Kang Law

Fergus Doubal

NIKOLA SPRIGG nikola.sprigg@nottingham.ac.uk
Professor of Stroke Medicine

PHILIP BATH philip.bath@nottingham.ac.uk
Stroke Association Professor of Stroke Medicine

Joanna M. Wardlaw



Abstract

Background: Cilostazol and isosorbide mononitrate (ISMN) have properties that may be of benefit in the context of cerebral small vessel disease and lacunar ischaemic stroke. As both drugs may influence platelet and haemoglobin levels, we sought to assess their effects using data from the lacunar intervention trial-1 (LACI-1).

Methods: LACI-1 recruited 57 patients with lacunar ischaemic stroke and randomised them to ISMN or cilostazol in isolation, or combined for 9 weeks. One group received both drugs but with a delayed start. Full blood counts were taken at baseline, and weeks 3 and 8. Platelet function was assessed with remote measurement of surface expression of P-selectin (CD62P) using kits sensitive to aspirin or clopidogrel at the same timepoints. Differences in haemoglobin and platelet levels and platelet function were assessed by multiple linear regression with adjustment for baseline value.

Results: Haemoglobin levels did not differ between the treatment groups at week 8 (Table), whilst platelet levels were slightly higher in those who received cilostazol compared with no cilostazol. No differences were noted in platelet function in unstimulated, aspirin or clopidogrel testing between groups.

Conclusions: Cilostazol and isosorbide mononitrate have no clinically concerning effects on haemoglobin and platelet levels and function in the short to medium term. Further assessment of the safety and efficacy of these medications following lacunar ischaemic stroke is warranted.

Citation

Appleton, J. P., Flaherty, K., Blair, G. W., Law, Z. K., Doubal, F., Sprigg, N., …Wardlaw, J. M. (2018). Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial.

Conference Name 4th European Stroke Organisation Conference ​(ESOC 2018)
End Date May 18, 2018
Acceptance Date Feb 22, 2018
Publication Date May 16, 2018
Deposit Date Apr 20, 2018
Publicly Available Date May 16, 2018
Peer Reviewed Not Peer Reviewed
Public URL https://nottingham-repository.worktribe.com/output/932371

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