Biomedical Engineering Reference
In-Depth Information
1.0
1.0
.9
.9
.8
.8
.7
.7
.6
.6
.5
.5
0
20
40
60
80
100
120 140
0
20
40
60
80
100
120 140
Duration (months)
Duration (months)
1.0
.9
.8
.7
.6
.5
0
20
40
60
80
100
120
140
Duration (months)
Fig. 4
Incidence of brain infarction related to levels of hs-CRP and sICAM-1 at baseline in type
2 diabetic patients. (a) Brain infarction event-free rates in relation to sICAM-1 levels. (b) Event-
free rates in relation to hs-CRP levels by tertile. (c) Event-free rates in relation to both sICAM-1
and hs-CRP levels by combinations of highest tertile and lower tertile (lowest tertile + middle
tertile).
necessary to look into this in the future. Aspirin, dipyridamol and clopidogrel
are used globally as secondary prevention in ischemic stroke and while there is
no doubt concerning their ei cacy for atherothrombosis, it is unclear whether
they are ef ective for lacunar infarctions or not. Current therapy to prevent the
progression of SVD with SBI and WMLs, therefore, consists mainly of risk factor
management. Cilostazol, a selective inhibitor of phosphodiesterase 3(PDE3),
is only approved for intermittent claudication in the United States and United
Kingdom, while it is approved under the national health insurance for the
secondary prevention of noncardioembolic ischemic stroke in Japan, Korea,
China and other Asian countries. Cilostazol has pleiotrophic ef ects which, besides
inhibition of platelet aggregation, include vasodilation, improvement of vascular
endothelium function, reduction of AM and inhibition of vascular smooth muscle
cell proliferation. It has also been observed to prevent the progression of carotid
intima-media thickness and the recurrence of lacunar infarction. In previous
study, cilostazol signii cantly inhibited the expression of ICAM-1 and P-selectin
