SynthesisStroke2020
Cilostazol for Secondary Prevention of Stroke and Cognitive Decline: Systematic Review and Meta-Analysis.
Synthesis in Stroke, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 9 of them syntheses that pooled 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.
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.
Who cites it
49 citing papers in PubMed, 9 syntheses or guidelines pooled it, 89 citations in OpenAlex.
- Efficacy and safety of using cilostazol versus aspirin in secondary stroke prevention: systematic review and meta-analysis of randomised controlled clinical trials.Internal medicine journal · 2025Pooled it
- New options for cilostazol-based dual antiplatelet therapy for ischaemic stroke prevention in East Asian populations: a systematic review and meta-analysis.Frontiers in pharmacology · 2025Pooled it
- European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke.European stroke journal · 2024Guideline
- The Role of Cilostazol, a Phosphodiesterase-3 Inhibitor, in the Development of Atherosclerosis and Vascular Biology: A Review with Meta-Analysis.International journal of molecular sciences · 2024Pooled it
- Contemporary antiplatelet therapy for secondary stroke prevention: a narrative review of current literature and guidelines.Stroke and vascular neurology · 2022Pooled it
- The role ofExpert review of clinical pharmacology · 2022Pooled it
- The Efficacy and Safety of Cilostazol vs. Aspirin for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis.Frontiers in neurology · 2022Pooled it
- Cilostazol for secondary stroke prevention: systematic review and meta-analysis.Stroke and vascular neurology · 2021Pooled it
- Aspirin in people with dementia, long-term benefits, and harms: a systematic review.European journal of clinical pharmacology · 2021Pooled it
- Cilostazol Contributes to Risk Reduction of Stroke Recurrence without Mediating a Reduction of Blood Pressure: Results from CSPS.com.Journal of atherosclerosis and thrombosis · 2026Trial
- Cilostazole versus clopidogrel in acute large-vessel moderate and moderate-to-severe ischemic stroke: a randomized controlled trial.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Trial
- 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 · 2024Trial
- Cilostazol treatment for preventing adverse cardiovascular events in patients with type 2 diabetes and coronary atherosclerosis: Long-term follow-up of the ESCAPE study.Journal of diabetes · 2022Trial
- Improvement of poststroke cognitive impairment by intermittent theta bursts: A double-blind randomized controlled trial.Brain and behavior · 2022Trial
- Association of Timing for Starting Dual Antiplatelet Treatment With Cilostazol and Recurrent Stroke: A CSPS.com Trial Post Hoc Analysis.Neurology · 2022Trial
- Effects of Cilostazol and Isosorbide Mononitrate on Cerebral Hemodynamics in the LACI-1 Randomized Controlled Trial.Stroke · 2022Trial
- Article
- Comparative effectiveness of cilostazol and aspirin in ischemic stroke: a retrospective cohort study.Acta neurologica Belgica · 2026Article
- CILO-CLOP Trial: Cilostazol Versus Clopidogrel in Acute Moderate and Moderate-to-Severe Ischemic Stroke: A Randomized Controlled Multicenter Trial.Neurology and therapy · 2025Article
- Prevalence of Aspirin or Clopidogrel Pharmacological Resistance in Ischemic Stroke: A Step Toward Precision Medicine.CNS neuroscience & therapeutics · 2025Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
background and purposeCilostazol, a phosphodiesterase 3' inhibitor, is used in Asia-Pacific countries for stroke prevention, but rarely used elsewhere. In addition to weak antiplatelet effects, it stabilizes endothelium, aids myelin repair and astrocyte-neuron energy transfer in laboratory models, effects that may be beneficial in preventing small vessel disease progression.
methodsA systematic review and meta-analysis of unconfounded randomized controlled trials of cilostazol to prevent stroke, cognitive decline, or radiological small vessel disease lesion progression. Two reviewers searched for papers (January 1, 2019 to July 16, 2019) and extracted data. We calculated Peto odds ratios (ORs) and 95% CIs for recurrent ischemic, hemorrhagic stroke, death, adverse symptoms, with sensitivity analyses. The review is registered (CRD42018084742).
resultsWe included 20 randomized controlled trials (n=10 505), 18 in ischemic stroke (total n=10 449) and 2 in cognitive impairment (n=56); most were performed in Asia-Pacific countries. Cilostazol decreased recurrent ischemic stroke (17 trials, n=10 225, OR=0.68 [95% CI, 0.57-0.81];
conclusionsCilostazol appears effective for long-term secondary stroke prevention without increasing hemorrhage risk. However, most trials related to Asia-Pacific patients and more trials in Western countries should assess its effects on cognitive decline, functional outcome, and tolerance, particularly in lacunar stroke and other presentations of small vessel disease.
Indexed as
Identifiers
What OpenQuestion holds
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.