Meta-analysis of cilostazol versus aspirin for the secondary prevention of stroke

DiNicolantonio, James J., Lavie, Carl J., Fares, Hassan, Menezes, Arthur R., O'Keefe, James H., Bangalore, Sripal and Messerli, Franz H. (2013) Meta-analysis of cilostazol versus aspirin for the secondary prevention of stroke. American Journal of Cardiology, 112 8: 1230-1234. doi:10.1016/j.amjcard.2013.05.067


Author DiNicolantonio, James J.
Lavie, Carl J.
Fares, Hassan
Menezes, Arthur R.
O'Keefe, James H.
Bangalore, Sripal
Messerli, Franz H.
Title Meta-analysis of cilostazol versus aspirin for the secondary prevention of stroke
Journal name American Journal of Cardiology   Check publisher's open access policy
ISSN 0002-9149
1879-1913
Publication date 2013-10-01
Sub-type Article (original research)
DOI 10.1016/j.amjcard.2013.05.067
Volume 112
Issue 8
Start page 1230
End page 1234
Total pages 5
Place of publication Bridgewater, NJ, United States
Publisher Excerpta Medica
Collection year 2014
Language eng
Abstract Aspirin is the most widely prescribed antiplatelet agent for the secondary prevention of stroke. Cilostazol, an antiplatelet and vasodilating agent, has shown promise for the secondary prevention of stroke. A systematic review and meta-analysis of randomized controlled trials using Ovid MEDLINE, PubMed, and Excerpta Medica (EMBASE) was searched up to October 2012. Four trials, in 3,917 patients, comparing cilostazol with aspirin were identified. Compared with aspirin, cilostazol was associated with a 73% reduction in hemorrhagic stroke (relative risk [RR] 0.27, 95% confidence interval [CI] 0.13 to 0.54, p = 0.0002), 28% reduction in the composite end point of stroke, myocardial infarction, or vascular death (RR 0.72, 95% CI 0.57 to 0.89, p = 0.003), and 48% reduction in total hemorrhagic events (RR 0.52, 95% CI 0.34 to 0.79, p = 0.002), with trend for lesser gastrointestinal bleeds (RR 0.60, 95% CI 0.34 to 1.06, p = 0.08). In conclusion, compared with aspirin, cilostazol is associated with significantly less hemorrhagic stroke, the combined end point of stroke, myocardial infarction, and vascular death, and total hemorrhagic events, with numerically fewer gastrointestinal bleeds when used for the secondary prevention of stroke.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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