Evidence map›Paper›PMID 40419917›Full record

Observational studyMedicine2025

Prognosis of patients with aneurysmal subarachnoid hemorrhage treated with fasudil hydrochloride-cilostazol combination therapy: A cross-sectional analysis of a nationwide inpatient database, 2016 to 2020.

Hiroshi Magara, Takuaki Tani, Shinobu Imai, Kensuke Yoshida, Kiyohide Fushimi, Munetoshi Sugiura

Abstract readObservational Study
In one paragraph

Observational study in Medicine, 2025. 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
–field-weighted citation impact
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.

  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

6 authors.

Hiroshi MagaraDepartment of Drug Safety and Risk Management, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.ORCID 0009-0004-8344-4543
Takuaki TaniDepartment of Pharmacoepidemiology, Showa University Graduate School of Pharmacy, Tokyo, Japan.
Shinobu ImaiDepartment of Pharmacoepidemiology, Showa University Graduate School of Pharmacy, Tokyo, Japan.
Kensuke YoshidaDepartment of Drug Safety and Risk Management, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
Kiyohide FushimiDepartment of Health Policy and Informatics, Institute of Science Tokyo Graduate School of Medical and Dental Sciences, Tokyo, Japan.
Munetoshi SugiuraDepartment of Drug Safety and Risk Management, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Fasudil hydrochloride is used as a therapeutic agent for cerebral vasospasm after aneurysmal subarachnoid hemorrhage surgery; however, its limited efficacy necessitates additional treatment options. Although the therapeutic potential of cilostazol for improved outcomes after aneurysmal subarachnoid hemorrhage has been reported, no clinical studies have examined the effects of administering both cilostazol and fasudil hydrochloride on mortality and physical disability in patients. Therefore, we investigated the impact of combined fasudil hydrochloride and cilostazol administration among patients with subarachnoid hemorrhage (SAH) in Japan. A cross-sectional study was conducted using the diagnosis procedure combination database among patients with SAH who received fasudil hydrocholoride alone (n = 8728) or in combination with cilostazol (n = 8052) between April 2016 and March 2020. The primary endpoint was in-hospital mortality, and the secondary endpoint was the proportion of patients with a modified Rankin Scale (mRS) score ≤2 at discharge. Statistical analysis was performed using multivariate-adjusted logistic regression analysis with a significance level of 5%. The mean age was 63.8 years (standard deviation [SD]: 14.4) in the fasudil hydrochloride monotherapy group (F group) and 62.8 years (SD: 14.3) in the fasudil hydrochloride and cilostazol combination group (FC group). Female patients accounted for 69.5% in the F group and 70.1% in the FC group. The in-hospital mortality rate was 7.4% in the F group and 4.0% in the FC group. Patients in the FC group had a lower in-hospital mortality rate than did those in the F group (odds ratio 0.28, 95% confidence interval [CI] 0.23-0.34, P < .001). The proportion of patients with an mRS score ≤2 at discharge was 49.4% in the F group and 55.7% in the FC group. Patients in the FC group had a higher mRS score ≤2 at discharge than those in the F group (odds ratio 1.43, 95% CI: 1.31-1.55, P < .001). We investigated the impact of combined fasudil hydrochloride and cilostazol administration on the prognosis of Japanese patients with SAH. The results suggest that combination therapy with fasudil hydrochloride and cilostazol may have a synergistic effectiveness on improving SAH prognosis compared with fasudil hydrochloride monotherapy. In future, research is needed to understand the mechanisms underlying the combined use of cilostazol.

Indexed as

1-(5-Isoquinolinesulfonyl)-2-MethylpiperazineCilostazolSubarachnoid HemorrhageAgedCross-Sectional StudiesDatabases, FactualDrug Therapy, CombinationFemaleHospital MortalityHumansJapanMaleMiddle AgedPrognosisTreatment OutcomeVasodilator Agents1-(5-Isoquinolinesulfonyl)-2-MethylpiperazineCilostazolfasudilVasodilator Agentscilostazoldiagnosis procedure combinationfasudil hydrochloridein-hospital mortalitymodified rankin scalesubarachnoid hemorrhage

Identifiers

PMID40419917
PMCPMC12113980

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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.