The Effect and Safety of Combined Anti-platelet Treatment in Acute Ischemic Stroke Due to Large Artery Atherosclerosis

Recruiting now · Phase 4 · Has a placebo group

Conditions studied: Cerebral Infarction, Stenosis Artery

In brief

Currently, aspirin plus clopidogrel is considered as a standard acute treatment of ischemic stroke, based on results of CHANCE and POINT trial. However, still a considerable portion of patients showed early stroke recurrence, especially in those with stroke due to large artery atherosclerosis. Cilostazol may have benefit in reducing early stroke recurrence of neurologic deterioriation. The post-hoc analysis of CSPS.com showed that use of cilostazol after 15 days of stroke was effective for preventing subsequent stroke. The effect of adding cilostazol was more effective in those with large artery atherosclerosis and those receiving clopidogrel than aspirin.

Key facts

Study ID

NCT06757764

Run by

Asan Medical Center

People needed

2340

Starts

2025-07-10

Expected to finish

2028-03-31

Last updated by the study team

2026-03-27

Who can join

Age: 20 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age of 20 years or older
• Acute ischemic stroke due to large artery atherosclerosis (both including Intra and extracranial atherosclerosis) which may be defined by a ischemic lesion confirmed at diffusion-weighted image and a corresponding significant stenosis (more than 50% of diameter reduction) proximal to the ischemic lesion confirmed by MR angiography or CT angiography.
• Informed consent obtained within 72h from stroke onset
• Acquisition of written informed consent prior to study entry

You may not qualify if…

• Large infarction unable to start antiplatelet treatment
• Combined with acute intracranial haemorrhage
• With initial haemorrhagic transformation
• Previous mRS higher than 2
• Indicated for anticoagulation
• Contraindication for aspirin, clopidogrel or cilostazol
• Requirement of long term NSAID
• Pre-planned for surgery
• Unable to withdraw consent
• Unavailable to participate based on judgement of the investigator
• Participants of reproductive potential (PORP)/ Participants of childbearing potential (POCBP) who do not agree to practice methods of birth control or remain fully abstinent from sexual activity with the potential for conception.

Where it is running

• Pusan National University Yangsan Hospital — Yangsan, South Korea (enrolling)
• Pusan National University Hospital — Busan, South Korea (enrolling)
• Chungbuk National University Hospital — Cheongju-si, South Korea (enrolling)
• Kyungpook National University Chilgok Hospital — Daegu, South Korea (enrolling)
• Chungnam National University Hospital — Daejeon, South Korea (enrolling)
• Eulji University Hospital — Daejeon, South Korea (enrolling)
• Chonnam National University Hospital — Gwangju, South Korea (enrolling)
• Seoul National University Bundang Hospital — Gyeonggi-do, South Korea (enrolling)
• Hallym University Medical Center — Gyeonggi-do, South Korea (enrolling)
• Hanyang University Guri Hospital — Gyeonggi-do, South Korea (enrolling)
• Korea University Ansan Hospital — Gyeonggi-do, South Korea (enrolling)
• Gachon University Gil Medical Center — Incheon, South Korea (enrolling)
• Inha University Hospital — Incheon, South Korea (enrolling)
• Jeju National University Hospital — Jeju City, South Korea (enrolling)
• Jeonbuk National University Hospital — Jeonju, South Korea (enrolling)
• Ewha Womans University Seoul Hospital — Seoul, South Korea (enrolling)
• Hanyang University Seoul Hospital — Seoul, South Korea (enrolling)
• Korea University Guro Hospital — Seoul, South Korea (enrolling)
• Kyung Hee University Hospital at Gangdong — Seoul, South Korea (enrolling)
• Kyung Hee University Hospital — Seoul, South Korea (enrolling)
• Samsung Medical Center — Seoul, South Korea (enrolling)
• The Catholic University of Korea, Seoul St. Mary's Hospital — Seoul, South Korea (enrolling)
• Asan Medical Center — Seoul, Songpa-gu, South Korea (enrolling)
• Yonsei University Health System, Gangnam Severance Hospital — Seoul, South Korea

Full record on ClinicalTrials.gov

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