SynthesisStroke and vascular neurology2021
Cilostazol for secondary stroke prevention: systematic review and meta-analysis.
Synthesis in Stroke and vascular neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
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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
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Aspirin plus clopidogrel versus cilostazol -based triple antiplatelet therapy in patients with ischemic heart disease undergoing PCI: a systematic review and meta-analysis of randomized controlled trials.BMC pharmacology & toxicology · 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
- The Efficacy and Safety of Cilostazol vs. Aspirin for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis.Frontiers in neurology · 2022Pooled it
- Efficacy and safety of sublingual cilostazol and dexborneol for the treatment of acute ischaemic stroke: a randomised phase 2 trial in China.EClinicalMedicine · 2026Article
- JAK/STAT signaling pathway inhibitors in neurodegenerative diseases: current status and future perspectives.Frontiers in aging neuroscience · 2026Review
- Polygenic risk score and cluster-based analysis suggests links between type 2 diabetes and vascular dementia in the KARE study.Nature communications · 2025Article
- Impact of cilostazol on clinical outcomes in lower extremity arterial disease patients after angioplasty: A real-world analysis.PloS one · 2025Article
- Dual Antiplatelet Therapy for the Acute Management and Long-term Secondary Prevention of Ischemic Stroke and Transient Ischemic Attack, An Updated Review.Journal of cardiovascular development and disease · 2024Review
- Long-term effectiveness and safety of cilostazol versus clopidogrel in secondary prevention of noncardioembolic ischemic stroke.European journal of clinical pharmacology · 2023Article
- Comparison of Cilostazol versus Clopidogrel in Addition to Aspirin in Patients with Ischemic Stroke who Underwent Intracranial or Extracranial Artery Stent Implantation.Journal of atherosclerosis and thrombosis · 2023Article
- Secondary Ischemic Stroke Prevention.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023Review
- Small-vessel disease in the brain.American heart journal plus : cardiology research and practice · 2023Article
- Early identification and treatment for peripheral arterial disease in patients with ischemic cerebrovascular disease.European journal of medical research · 2023Review
- Antiplatelet Use in Ischemic Stroke.The Annals of pharmacotherapy · 2022Review
- Rationale and design of the AXIOMATIC-SSP phase II trial: Antithrombotic treatment with factor XIa inhibition to Optimize Management of Acute Thromboembolic events for Secondary Stroke Prevention.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022Article
- Circulating Cytokines and Growth Factors in Acute Cerebral Large Vessel Occlusion-Association with Success of Endovascular Treatment.Thrombosis and haemostasis · 2022Article
- Recent advances in the management of transient ischemic attacks.Faculty reviews · 2022Review
- Antithrombotic Therapy in the Prevention of Stroke.Biomedicines · 2021Review
- A Clinical Update on Antiplatelet Therapy in Secondary Prevention of Ischemic Stroke.Current cardiology reports · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStroke is one of the leading causes of death worldwide. Cilostazol, an antiplatelet and phosphodiesterase 3 inhibitor, has not been clearly established for ischaemic stroke use. We aim to determine the efficacy and safety of cilostazol for secondary stroke prevention.
methodsMEDLINE, EMBASE, Cochrane Library, Web of Science and ClinicalTrials.gov were searched from inception to 25 September 2020, for randomised trials comparing the efficacy and safety of cilostazol monotherapy or dual therapy with another antiplatelet regimen or placebo, in patients with ischaemic stroke. Version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to assess study quality. This meta-analysis was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
resultsEighteen randomised trials comprising 11 429 participants were included in this meta-analysis. Most trials possessed low risk of bias and were of low heterogeneity. Cilostazol significantly reduced the rate of ischaemic stroke recurrence (risk ratio, RR=0.69, 95% CI 0.58 to 0.81), any stroke recurrence (RR=0.64, 95% CI 0.54 to 0.74) and major adverse cardiovascular events (RR=0.67, 95% CI 0.56 to 0.81). Cilostazol did not significantly decrease mortality (RR=0.90, 95% CI 0.64 to 1.25) or increase the rate of good functional outcome (Modified Rankin Scale score of 0-1; RR=1.07, 95% CI 0.95 to 1.19). Cilostazol demonstrated favourable safety profile, significantly reducing the risk of intracranial haemorrhage (RR=0.46, 95% CI 0.31 to 0.68) and major haemorrhagic events (RR=0.49, 95% CI 0.34 to 0.70).
conclusionsCilostazol demonstrated superior efficacy and safety profiles compared with traditional antiplatelet regimens such as aspirin and clopidogrel for secondary stroke prevention but does not appear to affect functional outcomes. Future randomised trials can be conducted outside East Asia, or compare cilostazol with a wider range of antiplatelet agents.
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