Neurology and Neurodisorders

Antiplatelet therapy lowers the risk of recurrent stroke. Policosanol has shown to reduce platelet aggregation in experimental and clinical studies. This study investigated whether policosanol plus aspirin (AS) could improve the neurological outcome as compared to placebo + AS in patients with a recent ischemic stroke. Ninety-two (92) patients with a modified Rankin Scale score (mRSs) ≥2 - ≤4 after suffering an ischemic stroke within 30 days before enrolment were randomized to placebo or policosanol (20 mg/day) + aspirin (AS) (125 mg/day) (pla + AS or poli + AS) for 6 months. The primary efficacy variable was to obtain a better stroke outcome (mRSs ≤1) compared to pla +AS. Platelet aggregation was a secondary variable. After 12 and 24 weeks on therapy, the rates of poli + AS patients who achieved mRSs ≤1 were significantly (p<0.01 and p<0.00001, respectively) greater than in the pla + AS group. Poli + AS given for 6 weeks reduced significantly (p<0.00001 vs baseline, p<0.01 vs pla + AS) the mean mRSs values (24.1%), and this effect improved thereafter, so that reductions of 31.0% and 55.2% were found after 12 and 24 weeks, respectively. Also, poli + AS reduced significantly arachidonic acid- (41.0%) and ADP-induced (24.8%) platelet aggregation. Treatments were well tolerated. There were not withdrawals due to adverse experiences. In conclusion, poli added to standard AS treatment improved the neurological recovery as compared to pla + AS, and decreased platelet aggregation in patients with recent ischemic stroke.