title: Systematic study of cilostazol on secondary stroke prevention: a meta-analysis.
abstract: BACKGROUND
  To study the efficacy and safety of cilostazol on ischemic stroke prevention and treatment, systematic reviews of related clinical randomized controlled trials were analyzed.
  
  
  METHODS
  We searched the main databases for eligible trials including literature from January 1966 to November 2012 in MEDLINE, reports from 1980 to November 2012 in EMBASE, and all the studies published in EBSCO, Springer, Ovid, and Cochrane library citations. We also searched for keywords, including cilostazol and aspirin. RewMan 5.0 software was used to conduct the meta-analysis.
  
  
  RESULTS
  Our search yielded five eligible trials. The effects of cilostazol and aspirin on ischemic stroke prevention and treatment were almost equal (combined odds ratio (OR) 0.78, 95% confidence interval (CI) (0.59, 1.04)). Additionally, both magnetic resonance angiography (MRA) and transcranial Doppler (TCD) examination showed that cilostazol could significantly decrease the incidence of intracranial artery stenosis exacerbation (MRA: combined OR 0.22, 95% CI (0.07, 0.68); TCD: combined OR 0.17, 95% CI (0.05, 0.51)). In terms of adverse reactions, there were slightly fewer incidences of major bleeding with cilostazol than with aspirin (combined OR 0.38, 95% CI (0.24, 0.60)), and there was no difference in the number of heart palpitations between cilostazol and aspirin. However, the incidence of gastrointestinal disorders, dizziness, and headaches caused by cilostazol was greater.
  
  
  CONCLUSIONS
  Cilostazol might be a more effective and safer alternative to aspirin for patients with ischemic stroke. Further studies are required to confirm whether cilostazol is a suitable therapeutic option for secondary stroke prevention in larger cohorts of patients with ischemic stroke.
authors: Yining
authors: Y
authors: Qian
authors: Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. biqidoctor@163.com.
authors: Qi
authors: Q
authors: Bi
mesh_terms: D001241:Aspirin / Q000627:therapeutic use; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D000077407:Cilostazol; D002986:Clinical Trials as Topic; D018450:Disease Progression; D006801:Humans; D015994:Incidence; D020765:Intracranial Arterial Diseases / Q000150:complications / Q000188:drug therapy; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D013777:Tetrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077407:Cilostazol; D001241:Aspirin