Randomized Trial Comparing Aspirin with Cilostazol or Clopidogrel for Large-Vessel Minor Stroke or Transient Ischemic Attack in Adults

What this Trial Is About

Researchers are investigating the safety and effectiveness of combining aspirin with either cilostazol or clopidogrel in adults who have experienced a first-ever large-vessel minor ischemic stroke or transient ischemic attack TIA. This randomized controlled trial compares a 300 mg loading dose of clopidogrel plus 300 mg aspirin to a 200 mg loading dose of cilostazol plus 300 mg aspirin, focusing on stroke prevention and possible side effects. The study is conducted under ethical approval and involves careful monitoring of neurological outcomes and complications. Participants are randomly assigned to one of two treatment groups. One group receives clopidogrel with a 300 mg loading dose followed by 75 mg daily from day 2 to day 90, alongside aspirin starting with a 300 mg loading dose and then 75 mg daily maintenance. The other group takes cilostazol with a 200 mg loading dose within 24 hours of stroke onset, then 100 mg twice daily through day 90, plus the same aspirin regimen. Both groups undergo clinical assessments and brain imaging to track progress and safety. Throughout the study, patients have neurological evaluations using the NIH Stroke Scale NIHSS and the Modified Rankin Scale mRS at admission, day 7, and three months. Additional tests include echocardiography, ECG monitoring, carotid duplex, blood tests, and brain MRI scans. Researchers measure the rate of new strokes and bleeding complications at 90 days, along with secondary outcomes like stroke recurrence, heart attacks, deaths from vascular causes, and treatment side effects. Participants are followed for 90 days to monitor safety and effectiveness.

Combining Aspirin With Cilostazol or Clopidogrel in Large-vessel Minor Stroke or TIA