Key result
Cilostazol-based DAPT reduces recurrent ischemic stroke vs monotherapy in high-risk Japanese patients.
Why the study?
Prior meta-analyses showed cilostazol reduced recurrent ischemic stroke and vascular events, but the safety and efficacy of dual therapy with cilostazol in high-risk ischemic stroke patients required evaluation.
Does dual antiplatelet therapy with cilostazol reduce recurrent ischemic stroke compared to monotherapy in high-risk Japanese patients?
Does dual antiplatelet therapy with cilostazol reduce recurrent ischemic stroke compared to monotherapy in high-risk Japanese patients?
Dual antiplatelet therapy with cilostazol reduces recurrent ischemic stroke in high-risk Japanese patients, though with differences in hemorrhagic complications compared to monotherapy.
May support cilostazol DAPT in high-risk Japanese patients; hypothesis-generating and requires randomized confirmation before wider use.
BACKGROUND: Prior meta-analyses showed that treatment with cilostazol, with or without aspirin, significantly reduced the incidence of recurrent ischemic stroke, occurrence of hemorrhagic stroke, and frequency of other serious vascular adverse events. METHODS: . entitled, "Dual antiplatelet therapy using cilostazol for secondary prevention in patients with high-risk ischemic stroke in Japan: a multicenter, open-label, randomized controlled trial." Here, dual therapy consisting of cilostazol and another antiplatelet agent was used to prevent secondary ischemic stroke in high-risk Japanese patients. RESULTS: Patients on dual therapy consisting of cilostazol/aspirin or cilostazol/clopidogrel had significantly lower frequencies of recurrent stroke. However, there were significant differences in the incidence of attendant hemorrhagic complications utilizing mono or dual therapy. CONCLUSION: This RCT demonstrated the safety of dual therapy, consisting of cilostazol/aspirin or cilostazol/ clopidogrel, in preventing secondary ischemic stroke in a high-risk Japanese population. Further studies are required to generalize these findings to other patient populations worldwide.
No takes yet. Share an insight, caveat, or question.
Lo et al. (2020) conducted a review in high-risk ischemic stroke. Dual antiplatelet therapy (cilostazol and aspirin or clopidogrel) vs. Monotherapy was evaluated on recurrent ischemic stroke. Dual antiplatelet therapy with cilostazol and aspirin or clopidogrel significantly lowered the frequency of recurrent stroke compared to monotherapy in high-risk Japanese patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: