In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. Suppl_1 ( 2018-01-22)
Abstract:
Objective: Extensive research has long been focused on improving morbidity and mortality related to cerebral vasospasm which is well known as a major complication in subarachnoid hemorrhage (SAH) patients. The aim of this meta-analysis is to assess the effectiveness of cilostazol, a selective inhibitor of phosphodiesterase Type III, on cerebral vasospasm after SAH. Methods: Randomized and non randomized studies that compared effectiveness of cilostazol in SAH were included. A total of 6 trials met the inclusion criteria and were included in the meta-analysis. We calculated pooled risk ratios (RR) and 95% CIs (confidence intervals) using random-effects models. Primary end point was symptomatic vasospasm. Secondary end points were angiographic vasospasm, new cerebral infarct, mortality, and functional outcome i.e Modified Rankin scale ≤ 2. Results: Of the 618 total subjects, total of 136 (22%) symptomatic vasospasm events occurred during the follow-up period. The RR of symptomatic vasospasm was lower in patients treated with Cilostazol (RR = 0.43; 95% CI, 0.31-0.60; P 〈 0.001). Angiographic vasospasm was also significantly lower among those who received cilostazol as compared to control group (RR 0.67, 95% CI 0.51-0.84, p = .001). Cilostazol was associated with lower likelihood of new cerebral infarct in comparison to best medical therapy (RR 0.33 CI 95% 0.20-0.54, p 〈 0.001). There was no difference between the risk of mortality between subjects who received airway cilostazol compared with those who were in control group (RR 0.64 CI 95% 0.15-2.76, p=0.55). There was improvement of mRS noted in patients who received cilostazol therapy (RR 1.21 CI 95% 1.05-1.39, p=0.008). Conclusion: Cilostazol administration may improve the outcome of patients with SAH. Further studies are needed to confirm this efficacy of cilostazol
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/str.49.suppl_1.37
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2018
detail.hit.zdb_id:
1467823-8
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