Antiplatelet cilostazol is effective in the prevention of pneumonia in ischemic stroke patients in the chronic stage.

We have previously reported that the phosphodiesterase inhibitor cilostazol, an antiplatelet agent, is effective and safe for secondary prevention of recurrent cerebral infarction (Cilostazol Stroke Prevention Study; CSPS). We now report the efficacy of this drug in the prevention of pneumonia in the chronic stage of cerebral infarction as a part of our CSPS subgroup analysis. The analysis was conducted in 1,049 subjects; 524 in the cilostazol group and 525 in the placebo group. The incidences of pneumonia during the 3.3-year follow-up were 2.86% (15 in 525 patients) in the placebo group and 0.57% (3 in 524 patients) in the cilostazol group, with a significant reduction in the cilostazol group. The rates of complications and pneumonia risk factors showed no difference between the two groups. We conclude that the administration of cilostazol to patients with cerebral infarction in the chronic stage does not only reduce the recurrence of infarction but also the incidence of pneumonia at least in Japanese patients.