Evidence map›Paper›PMID 30739182›Full record

SynthesisJournal of neurology2020

Effectiveness and feasibility of cilostazol in patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.

Tikun Shan, Tiejun Zhang, Weiqiang Qian, Lu Ma, Hao Li, Chao You, Xiaoqi Xie

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 10% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Review
  6. 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

7 authors at 2 institutions in 1 country.

Tikun Shan *Department of Neurosurgery, West China Hospital, Sichuan University and West China Brain Research Centre, No. 37 Guo Xue Xiang, Chengdu, Sichuan, China.
Tiejun Zhang *Department of Neurosurgery, West China Hospital, Sichuan University and West China Brain Research Centre, No. 37 Guo Xue Xiang, Chengdu, Sichuan, China.
Weiqiang QianDepartment of Neurosurgery, West China Hospital, Sichuan University and West China Brain Research Centre, No. 37 Guo Xue Xiang, Chengdu, Sichuan, China.
Lu MaDepartment of Neurosurgery, West China Hospital, Sichuan University and West China Brain Research Centre, No. 37 Guo Xue Xiang, Chengdu, Sichuan, China.
Hao LiDepartment of Neurosurgery, West China Hospital, Sichuan University and West China Brain Research Centre, No. 37 Guo Xue Xiang, Chengdu, Sichuan, China.
Chao YouDepartment of Neurosurgery, West China Hospital, Sichuan University and West China Brain Research Centre, No. 37 Guo Xue Xiang, Chengdu, Sichuan, China. chaoyou0118@126.com.
Xiaoqi XieDepartment of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China. xiaoqixie_nicu@163.com.
Sichuan University · CNWest China Hospital of Sichuan University · CN

Funding

1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University No. ZY2016102National Natural Science Foundation of China (CN) No. 81501003
6 · The paper itself

Abstract

backgroundDelayed cerebral ischemia seriously affects the prognosis of patients surviving the initial aneurysmal subarachnoid hemorrhage. Application of cilostazol was reported to ameliorate vasospasm and improve outcomes in series and clinical trials. But the effectiveness and feasibility of cilostazol on aneurysmal subarachnoid hemorrhage remained controversial. We performed a systematic review to clarify this issue.

methodsPubMed, Ovid and Cochrane library database were systematically searched up to May 2018 for eligible publications in English. Quality assessment was conducted for included studies. Meta-analysis was conducted to evaluate the overall effect on events of interest. Subgroup analyses and sensitivity analyses were used to check whether the results were robust. Publication bias was evaluated with the funnel plot.

resultsPooled analyses found cilostazol significantly reduced incidences of severe angiographic vasospasm (p = 0.0001), symptomatic vasospasm (p < 0.00001), new cerebral infarction (p < 0.00001) and the poor outcome (p < 0.0001). Subgroup and sensitivity analyses achieved consistent results. There was no statistical difference between cilostazol and the control group in reducing mortality (p = 0.07). But sensitivity analysis changed the result after excluding one study. Under the prescribed dosage, complication was few and non-lethal.

conclusionsCilostazol was effective and safe to reduce incidences of severe angiographic vasospasm, symptomatic vasospasm, new cerebral infarction and poor outcome in patients after aneurysmal subarachnoid hemorrhage. However, its effect on mortality and the interactive effect with nimodipine warranted further research.

Indexed as

Outcome Assessment, Health CareBrain IschemiaCardiovascular AgentsCerebral InfarctionCilostazolHumansIntracranial AneurysmSubarachnoid HemorrhageVasospasm, IntracranialCardiovascular AgentsCilostazolAneurysmCilostazolMeta-analysisSubarachnoid hemorrhageTreatment

Identifiers

PMID30739182
OpenAlexW2913150907

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.