Evidence map›Paper›PMID 25487817›Full record

Trial reportInternational journal of stroke : official journal of the International Stroke Society2015

Protocol for Cilostazol Stroke Prevention Study for Antiplatelet Combination (CSPS.com): a randomized, open-label, parallel-group trial.

Kazunori Toyoda, Shinichiro Uchiyama, Haruhiko Hoshino, Kazumi Kimura, Hideki Origasa, Hiroaki Naritomi, Kazuo Minematsu, Takenori Yamaguchi, CSPS.com Study Investigators

3 registry-linked trialsOpen access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in International journal of stroke : official journal of the International Stroke Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01995370 phase4completednot on this map

Cilostazol Stroke Prevention Study for Antiplatelet Combination

TypeinterventionalSponsorJapan Cardiovascular Research FoundationRan2013 to 2018Enrolled1,884ConditionsNoncardioembolic Cerebral InfarctionArmsaspirin, clopidogrel, cilostazol
NCT02983214 phase4completednot on this mapstarted 2016, after this paper: background citation

Study of the Efficacy and Safety of Cilostazol in the Prevention of Ischemic Vascular Events in Diabetic Patients With Symptomatic Peripheral Artery Disease.

TypeinterventionalSponsorUniversity of IoanninaRan2016 to 2019Enrolled826ConditionsIschemic Stroke, Peripheral Artery Disease, Diabetes Mellitus, Type 2ArmsClopidogrel, Cilostazol
NCT06196047 phase3recruitingnot on this mapstarted 2023, after this paper: background citation

Ticagrelor Versus Cilostazol in Ischemic Stroke

TypeinterventionalSponsorKafrelsheikh UniversityRan2023 to 2024Enrolled900ConditionsIschemic StrokeArmsTicagrelor 90 MG, Cilostazol 100 MG
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Blood pressure during long-term cilostazol-based dual antiplatelet therapy after stroke: a post hoc analysis of the CSPS.com trial.Hypertension research : official journal of the Japanese Society of Hypertension · 2024
    Trial
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Article
  10. Review
  11. Review
  12. Review
  13. Article
  14. Article
  15. Antithrombotic Management After Intracranial Hemorrhage.Current treatment options in cardiovascular medicine · 2019
    Review
  16. Treatment Approaches to Lacunar Stroke.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2019
    Review
  17. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Kazunori ToyodaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, 565-8565, Japan.
Shinichiro Uchiyama
Haruhiko Hoshino
Kazumi Kimura
Hideki Origasa
Hiroaki Naritomi
Kazuo Minematsu
Takenori Yamaguchi
CSPS.com Study Investigators
National Cerebral and Cardiovascular Center · JPInternational University of Health and Welfare · JPNippon Medical School · JPSaiseikai Central Hospital · JPUniversity of Toyama · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

RATIONALE AND

aimsMonotherapy with antiplatelet agents is only modestly effective in secondary prevention of ischemic stroke (IS), particularly in patients with multiple risk factors such as cervicocephalic arterial stenosis, diabetes, and hypertension. While dual antiplatelet therapy (DAPT) with aspirin and clopidogrel reduced IS recurrence, particularly in the early stages after IS, it increased the risk of bleeding. Compared with aspirin, cilostazol prevented IS recurrence without increasing the incidence of serious bleeds. In patients with intracranial arterial stenosis, no significant increase in bleeding events was observed for DAPT with cilostazol and aspirin, compared to that for aspirin monotherapy. DAPT involving cilostazol may therefore be safer than conventional DAPT. These findings prompted us to conduct the Cilostazol Stroke Prevention Study for Antiplatelet Combination (CSPS.com; ClinicalTrials.gov identifier: NCT01995370) to evaluate the safety and efficacy of DAPT involving cilostazol for secondary IS prevention, in comparison with that of antiplatelet monotherapy.

designThe CSPS.com is a multicenter, randomized, open-label, parallel-group trial. A total of 4000 high-risk patients with noncardioembolic IS will be randomized 8-180 days after onset to receive aspirin or clopidogrel monotherapy, or DAPT with cilostazol and aspirin or clopidogrel for at least one-year. STUDY OUTCOMES: The primary outcome is IS recurrence. Secondary outcomes are composite occurrences of any stroke, death from any cause, myocardial infarction, vascular death, and other vascular events. DISCUSSION: The CSPS.com is expected to provide evidence indicating whether secondary IS prevention in high-risk patients can be improved by using DAPT involving cilostazol.

Indexed as

AgedAspirinBrain IschemiaCilostazolClopidogrelDrug Therapy, CombinationHumansPhosphodiesterase 3 InhibitorsPlatelet Aggregation InhibitorsRecurrenceResearch DesignStrokeTetrazolesTiclopidineAspirinCilostazolClopidogrelPhosphodiesterase 3 InhibitorsPlatelet Aggregation InhibitorsTetrazolesTiclopidineaspirincerebral infarctioncilostazolclinical trialclopidogreldual antiplatelet therapyischemic strokestroke prevention

Identifiers

PMID25487817
PMCPMC4335602
OpenAlexW2016341115

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.