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Stroke prevention by cilostazol in patients with atherothrombosis: meta-analysis of placebo-controlled randomized

Shinichiro Uchiyama1, Bart M Demaerschalk, Shinya Goto

  • 1Department of Neurology, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Tokyo, Japan. suchiyam@nij.twmu.ac.jp

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|November 11, 2009
PubMed

Insights

Cilostazol significantly reduces cerebrovascular events in atherothrombosis patients, according to this meta-analysis. The antiplatelet drug showed no increased risk of bleeding complications.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Pharmacology

Background:

  • Cilostazol is an antiplatelet agent inhibiting phosphodiesterase III.
  • Previous trials on cilostazol for cerebrovascular event prevention yielded mixed results.

Purpose of the Study:

  • To systematically review and meta-analyze randomized clinical trials.
  • To determine cilostazol's effects on cerebrovascular, cardiac, and vascular events, and major bleeding in atherothrombosis patients.

Main Methods:

  • Systematic review and meta-analysis of 12 randomized controlled trials.
  • Involved 5674 patients with peripheral arterial disease, cerebrovascular disease, or coronary stenting.
  • Data analyzed for cerebrovascular, cardiac, and major bleeding events.

Main Results:

  • Cilostazol significantly reduced total vascular events (RR, 0.86; P=.038).
  • Cerebrovascular event incidence significantly decreased with cilostazol (RR, 0.58; P < .001).
  • No significant difference in cardiac events or major bleeding.

Conclusions:

  • Cilostazol significantly reduces cerebrovascular event risk in atherothrombosis.
  • This meta-analysis shows no increased bleeding risk associated with cilostazol.
Abstract

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