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A combination therapy consisting of isosorbide mononitrate (ISMN), a nitric oxide donor, and cilostazol, a phosphodiesterase-3 inhibitor. This combination targets cerebrovascular dysfunction through complementary pathways, with ISMN augmenting the NO-cyclic guanosine monophosphate pathway and cilostazol enhancing the prostacyclin-cyclic adenosine monophosphate pathway. Clinical trials have shown promise in reducing adverse outcomes after lacunar ischemic stroke, including recurrent stroke, cognitive impairment, and dependence.
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