Use Of Cilostazol For Preventing Ischemic Stroke Recurrence: A Meta Analysis

Objective To assess the clinical efficacy and safety of Cilostazol compared to Aspirin for preventing ischemic stroke recurrence.Methods We searched database PubMed (1966-2010.11), The Cochrane Library(2010.11),EMBASE(1974-2010.11),CNKI(1994-2010.11),CBM (1978-2010.11) and VIP (1989-2010.11)for randomized controlled trials on the use of Cilostazol compared to Aspirin to prevent ischemic stroke recurrence (up to November,2010). Two researchers read and selected studies then extracted data independently using an advanced and designed extraction form. Evaluated the quality of included trials according to the Cochrane handbook 5.0.1 then RevMan 5.0 software was used for Meta analysis.Results Four randomized controlled trials involving 3916 patients were identified. The results of meta-analysis showed that there was a significant difference was found between cilostazol and aspirin in hemorrhagic stroke occurrence (OR=0.38.95%CI (0.23.0.60), P<0.0001),headache occurrence (OR=2.17,95%CI (1.25,3.78), P=0.006) and dizziness occurrence (OR=1.47,95%CI (1.15,1.89). P=0.002). There was no statistical difference in ischemic stroke recurrence (OR=0.78.95%CI (0.59,1.04), P=0.09) and transient ischemic attack occurrence(OR=0.93,95%Cl (0.45,1.94), P=0.85) between the two groups.Conclusion Current evidence indicates that cilostazol have the same efficacy as aspirin to preventing ischemic stroke recurrence,but have less hemorrhagic stroke occurrence than aspirin.