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

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 int...

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Main Authors: Appleton, Jason P., Flaherty, Katie, Blair, Gordon W., Law, Zhe Kang, Doubal, Fergus, Sprigg, Nikola, Bath, Philip M., Wardlaw, Joanna M.
Format: Conference or Workshop Item
Published: 2018
Online Access:https://eprints.nottingham.ac.uk/51290/
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author Appleton, Jason P.
Flaherty, Katie
Blair, Gordon W.
Law, Zhe Kang
Doubal, Fergus
Sprigg, Nikola
Bath, Philip M.
Wardlaw, Joanna M.
author_facet Appleton, Jason P.
Flaherty, Katie
Blair, Gordon W.
Law, Zhe Kang
Doubal, Fergus
Sprigg, Nikola
Bath, Philip M.
Wardlaw, Joanna M.
author_sort Appleton, Jason P.
building Nottingham Research Data Repository
collection Online Access
description 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.
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institution_category Local University
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publishDate 2018
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spelling nottingham-512902020-05-04T19:36:25Z https://eprints.nottingham.ac.uk/51290/ 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. 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. 2018-05-16 Conference or Workshop Item NonPeerReviewed Appleton, Jason P., Flaherty, Katie, Blair, Gordon W., Law, Zhe Kang, Doubal, Fergus, Sprigg, Nikola, Bath, Philip M. and Wardlaw, Joanna M. (2018) Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial. In: 4th European Stroke Organisation Conference ​(ESOC 2018), 16-18 May 2018, Gothenburg, Sweden.
spellingShingle 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
title Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial
title_full Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial
title_fullStr Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial
title_full_unstemmed Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial
title_short Platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the LACI-1 trial
title_sort platelet and haemoglobin levels in patients on isosorbide mononitrate and/or cilostazol with lacunar ischaemic stroke: data from the laci-1 trial
url https://eprints.nottingham.ac.uk/51290/