Key result
Cilostazol significantly reduced the incidence of hemorrhagic stroke compared to aspirin among patients with prior lacunar stroke (HR 0.35; 95% CI 0.18-0.70; p<0.01).
Why the study?
Does cilostazol reduce the risk of hemorrhagic stroke compared to aspirin in patients with prior ischemic stroke who are at high risk of bleeding?
RCT
Does cilostazol reduce the risk of hemorrhagic stroke compared to aspirin in patients with prior ischemic stroke who are at high risk of bleeding?
Hazard Ratio: 0.35 (95% CI 0.18–0.7)
Absolute Event Rate: 0.36% vs 1.2%
p-value: p=<0.01
Cilostazol may be a safer therapeutic option than aspirin for secondary stroke prevention in patients at high risk for hemorrhagic events, such as those with prior lacunar stroke or elevated blood pressure.
No takes yet. Share an insight, caveat, or question.
May support cilostazol in high-bleeding-risk lacunar stroke; hypothesis-generating and requires RCTs before practice change.
Uchiyama et al. (2014) conducted an RCT in Prior ischemic stroke. Cilostazol vs. Aspirin was evaluated on Hemorrhagic stroke in patients with prior lacunar stroke (HR 0.35, 95% CI 0.18-0.70, p=<0.01). Cilostazol significantly reduced the incidence of hemorrhagic stroke compared to aspirin among patients with prior lacunar stroke (HR 0.35; 95% CI 0.18-0.70; p<0.01).
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