Evidence map›Paper›PMID 36070920›Full record

Trial reportJournal of atherosclerosis and thrombosis2023

Sex Difference in the Impact of Dual Antiplatelet Therapy using Cilostazol for Secondary Stroke Prevention: A Sub-Analysis of CSPS.com.

Haruhiko Hoshino, Kazunori Toyoda, Katsuhiro Omae, Kaito Takahashi, Shinichiro Uchiyama, Kazumi Kimura, Keiji Yamaguchi, Kazuo Minematsu, Hideki Origasa, Takenori Yamaguchi

Open access · diamondAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of atherosclerosis and thrombosis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 29% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. 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

10 authors at 7 institutions in 1 country.

Haruhiko HoshinoDepartment of Neurology, Tokyo Saiseikai Central Hospital.
Kazunori ToyodaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Katsuhiro OmaeDepartment of Biostatistics, National Cerebral and Cardiovascular Center.
Kaito TakahashiDepartment of Biostatistics, National Cerebral and Cardiovascular Center.
Shinichiro UchiyamaClinical Research Center for Medicine, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Medical Center.
Kazumi KimuraDepartment of Neurology, Nippon Medical School.
Keiji YamaguchiDepartment of Neurology, Ichinomiya Nishi Hospital.
Kazuo MinematsuHeadquarters of the Iseikai Medical Corporation.
Hideki OrigasaDivision of Biostatistics and Clinical Epidemiology, University of Toyama.
Takenori YamaguchiDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
National Cerebral and Cardiovascular Center · JPInternational University of Health and Welfare · JPKishokai Medical Corporation · JPNippon Medical School · JPNishijin Hospital · JPSaiseikai Central Hospital · JPUniversity of Toyama · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimAlthough some sex differences in stroke have been reported, differences in the effects of antiplatelet therapy for secondary stroke prevention have not been clarified.

methodsIn the Cilostazol Stroke Prevention Study combination trial, patients with high-risk, non-cardioembolic ischemic stroke between 8 and 180 days after onset treated with aspirin or clopidogrel alone were recruited and randomly assigned to receive either monotherapy or dual antiplatelet therapy (DAPT) using cilostazol and followed up for 0.5-3.5 years. The primary efficacy outcome was recurrence of ischemic stroke. The safety outcome was severe or life-threatening hemorrhage. Outcomes were analyzed by sex.

resultsA total of 1,320 male patients and 558 female patients were included. The male patients had more risk factors than the female patients. In male patients, the primary endpoint occurred at a rate of 2.0 per 100 patient-years in the DAPT group and 5.1 per 100 patient-years in the monotherapy group (hazard ratio (HR), 0.40; 95% confidence interval (CI), 0.23-0.68). In male patients, DAPT prolonged the time to recurrent stroke by 4.02-fold (95% CI, 1.63-9.96) compared with monotherapy. In female patients, the average annual event rates were 2.7 per 100 patient-years in the DAPT group and 3.3 per 100 patient-years in the monotherapy group (HR, 0.82; 95% CI, 0.37-1.84). Safety outcomes did not differ significantly in both male and female patients.

conclusionsLong-term DAPT using cilostazol reduced the recurrence of ischemic stroke and prolonged the recurrence-free time in male patients, but not in female patients.

Indexed as

Ischemic StrokeStrokeCilostazolDrug Therapy, CombinationFemaleHumansMalePlatelet Aggregation InhibitorsSecondary PreventionSex CharacteristicsCilostazolPlatelet Aggregation InhibitorsCilostazolDual antiplatelet therapyNon-cardioembolic ischemic strokeSex difference

Identifiers

PMID36070920
PMCPMC10244066
OpenAlexW4294878016

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
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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.