In the CSPS trial (Cilostazol for Prevention of Secondary Stroke), cilostazol was compared with placebo in 1095 Japanese patients with noncardioembolic ischemic stroke There was a sig- nificant reduction in the risk of recurrent stroke in the cilostazol treatment group and in partici- pants with lacunar stroke in the subgroup analy- sis. Cilostazol was compared with aspirin for the prevention of ischemic stroke in the CSPS II trial, which enrolled 2575 Japanese participants, 64% of whom had small vessel stroke as the qualify- Cilostazol was associated with a significantly reduced risk of first occurrence of ischemic or hemorrhagic stroke in the cilostazol group compared with the aspirin group. There were significantly fewer hemorrhagic events in the cilostazol group. There was a nonsignificant reduction in recurrent stroke risk in participants with small vessel stroke in the subgroup analysis. There were more reported side effects, includ- ing headache, dizziness, palpitations, diarrhea, tachycardia, and constipation, in the cilostazol group. These findings have not yet been dupli- cated, and the inclusion of a single ethnic group may limit generalizability. Knowledge Gaps and Future Research The role of cilostazol in secondary prevention after stroke related to small vessel disease. Targeted strategies for secondary prevention after small vessel stroke that also reduce the risk of vas- cular dementia. CLINICAL STATEMENTS AND GUIDELINES Kleindorfer 5.4.1. Atrial Fibrillation Recommendations for AF Referenced studies that support recommendations are summarized in online Data Supplement 32. 