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The Efficacy and Safety of Cilostazol vs. Aspirin for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis

BACKGROUND: Cilostazol is often used in Asia-Pacific countries for stroke prevention. The current systematic review and meta-analysis aimed to evaluate the effectiveness, safety, and adverse outcomes of cilostazol monotherapy compared to aspirin monotherapy for secondary stroke prevention. METHODS:...

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Autores principales: Chai, Erqing, Chen, Jinhua, Li, Changqing, Zhang, Xue, Fan, Zhiqiang, Yang, Shijie, Zhao, Kaixuan, Li, Wei, Xiao, Zaixing, Zhang, Yichuan, Tang, Futian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8885726/
https://www.ncbi.nlm.nih.gov/pubmed/35242099
http://dx.doi.org/10.3389/fneur.2022.814654
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author Chai, Erqing
Chen, Jinhua
Li, Changqing
Zhang, Xue
Fan, Zhiqiang
Yang, Shijie
Zhao, Kaixuan
Li, Wei
Xiao, Zaixing
Zhang, Yichuan
Tang, Futian
author_facet Chai, Erqing
Chen, Jinhua
Li, Changqing
Zhang, Xue
Fan, Zhiqiang
Yang, Shijie
Zhao, Kaixuan
Li, Wei
Xiao, Zaixing
Zhang, Yichuan
Tang, Futian
author_sort Chai, Erqing
collection PubMed
description BACKGROUND: Cilostazol is often used in Asia-Pacific countries for stroke prevention. The current systematic review and meta-analysis aimed to evaluate the effectiveness, safety, and adverse outcomes of cilostazol monotherapy compared to aspirin monotherapy for secondary stroke prevention. METHODS: The researchers conducted a comprehensive research in multiple databases (PubMed, Embase, and Cochrane library) of randomized controlled trials from conception to December 2020. The primary efficacy outcome was the occurrence of any stroke, the primary safety outcome was the bleeding risk, and the primary adverse outcome was the rate of headache and dizziness. The Mantel-Haenszel method was used to calculate a random-effects prediction. Cilostazol and aspirin were compared using a pooled risk assessment with 95% CIs. RESULTS: Six studies involving 5,617 patients were included in this review. Compared with aspirin monotherapy, cilostazol was associated with significantly lower rates of any strokes (RR: 0.67; 95% CI: 0.55–0.82) and significantly lower bleeding rates [risk ratio (RR): 0.53; 95% CI: 0.37–0.74]. However, compared with aspirin monotherapy, cilostazol was associated with significantly higher rates of headache (RR: 1.77; 95% CI: 1.41–2.20) and dizziness (RR: 1.28; 95% CI: 1.08–1.52). CONCLUSIONS: Consistent with previous studies, cilostazol monotherapy is superior to aspirin monotherapy in reducing the rate of any strokes and the bleeding risk after having a stroke. However, the use of cilostazol monotherapy is associated with several adverse life outcomes such as headaches and dizziness.
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spelling pubmed-88857262022-03-02 The Efficacy and Safety of Cilostazol vs. Aspirin for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis Chai, Erqing Chen, Jinhua Li, Changqing Zhang, Xue Fan, Zhiqiang Yang, Shijie Zhao, Kaixuan Li, Wei Xiao, Zaixing Zhang, Yichuan Tang, Futian Front Neurol Neurology BACKGROUND: Cilostazol is often used in Asia-Pacific countries for stroke prevention. The current systematic review and meta-analysis aimed to evaluate the effectiveness, safety, and adverse outcomes of cilostazol monotherapy compared to aspirin monotherapy for secondary stroke prevention. METHODS: The researchers conducted a comprehensive research in multiple databases (PubMed, Embase, and Cochrane library) of randomized controlled trials from conception to December 2020. The primary efficacy outcome was the occurrence of any stroke, the primary safety outcome was the bleeding risk, and the primary adverse outcome was the rate of headache and dizziness. The Mantel-Haenszel method was used to calculate a random-effects prediction. Cilostazol and aspirin were compared using a pooled risk assessment with 95% CIs. RESULTS: Six studies involving 5,617 patients were included in this review. Compared with aspirin monotherapy, cilostazol was associated with significantly lower rates of any strokes (RR: 0.67; 95% CI: 0.55–0.82) and significantly lower bleeding rates [risk ratio (RR): 0.53; 95% CI: 0.37–0.74]. However, compared with aspirin monotherapy, cilostazol was associated with significantly higher rates of headache (RR: 1.77; 95% CI: 1.41–2.20) and dizziness (RR: 1.28; 95% CI: 1.08–1.52). CONCLUSIONS: Consistent with previous studies, cilostazol monotherapy is superior to aspirin monotherapy in reducing the rate of any strokes and the bleeding risk after having a stroke. However, the use of cilostazol monotherapy is associated with several adverse life outcomes such as headaches and dizziness. Frontiers Media S.A. 2022-02-15 /pmc/articles/PMC8885726/ /pubmed/35242099 http://dx.doi.org/10.3389/fneur.2022.814654 Text en Copyright © 2022 Chai, Chen, Li, Zhang, Fan, Yang, Zhao, Li, Xiao, Zhang and Tang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Chai, Erqing
Chen, Jinhua
Li, Changqing
Zhang, Xue
Fan, Zhiqiang
Yang, Shijie
Zhao, Kaixuan
Li, Wei
Xiao, Zaixing
Zhang, Yichuan
Tang, Futian
The Efficacy and Safety of Cilostazol vs. Aspirin for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis
title The Efficacy and Safety of Cilostazol vs. Aspirin for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis
title_full The Efficacy and Safety of Cilostazol vs. Aspirin for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis
title_fullStr The Efficacy and Safety of Cilostazol vs. Aspirin for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis
title_full_unstemmed The Efficacy and Safety of Cilostazol vs. Aspirin for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis
title_short The Efficacy and Safety of Cilostazol vs. Aspirin for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis
title_sort efficacy and safety of cilostazol vs. aspirin for secondary stroke prevention: a systematic review and meta-analysis
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8885726/
https://www.ncbi.nlm.nih.gov/pubmed/35242099
http://dx.doi.org/10.3389/fneur.2022.814654
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