Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, February 6, 2021

Cilostazol for secondary stroke prevention: systematic review and meta-analysis

Did your doctor do ANYTHING AT ALL with these earlier pieces of research on Cilostazol including one on cognitive improvement?  Or is your doctor DOING NOTHING to recover your 5 lost years of brain cognition from your stroke?

 The latest here:

Cilostazol for secondary stroke prevention: systematic review and meta-analysiss

  1. Choon Han Tan1,
  2. Andrew GR Wu2,
  3. Ching-Hui Sia3,
  4. Aloysius ST Leow4,
  5. Bernard PL Chan4,
  6. Vijay Kumar Sharma2,4,
  7. Leonard LL Yeo2,4,
  8. Benjamin YQ Tan2,4
  1. Department of Medicine, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
  2. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  3. Department of Cardiology, National University Heart Centre, Singapore
  4. Division of Neurology, Department of Medicine, National University Health System, Singapore
  1. Correspondence to Dr Leonard LL Yeo; leonard_ll_yeo@nuhs.edu.sg
 

Author affiliations

  1. Department of Medicine, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
  2. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  3. Department of Cardiology, National University Heart Centre, Singapore
  4. Division of Neurology, Department of Medicine, National University Health System, Singapore
  1. Correspondence to Dr Leonard LL Yeo; leonard_ll_yeo@nuhs.edu.sg
 

Abstract

Background Stroke is one of the leading causes of death worldwide. Cilostazol, an antiplatelet and phosphodiesterase 3 inhibitor, has not been clearly established for ischaemic stroke use. We aim to determine the efficacy and safety of cilostazol for secondary stroke prevention.

Methods MEDLINE, EMBASE, Cochrane Library, Web of Science and ClinicalTrials.gov were searched from inception to 25 September 2020, for randomised trials comparing the efficacy and safety of cilostazol monotherapy or dual therapy with another antiplatelet regimen or placebo, in patients with ischaemic stroke. Version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to assess study quality. This meta-analysis was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Results Eighteen randomised trials comprising 11 429 participants were included in this meta-analysis. Most trials possessed low risk of bias and were of low heterogeneity. Cilostazol significantly reduced the rate of ischaemic stroke recurrence (risk ratio, RR=0.69, 95% CI 0.58 to 0.81), any stroke recurrence (RR=0.64, 95% CI 0.54 to 0.74) and major adverse cardiovascular events (RR=0.67, 95% CI 0.56 to 0.81). Cilostazol did not significantly decrease mortality (RR=0.90, 95% CI 0.64 to 1.25) or increase the rate of good functional outcome (Modified Rankin Scale score of 0–1; RR=1.07, 95% CI 0.95 to 1.19). Cilostazol demonstrated favourable safety profile, significantly reducing the risk of intracranial haemorrhage (RR=0.46, 95% CI 0.31 to 0.68) and major haemorrhagic events (RR=0.49, 95% CI 0.34 to 0.70).

Conclusions Cilostazol demonstrated superior efficacy and safety profiles compared with traditional antiplatelet regimens such as aspirin and clopidogrel for secondary stroke prevention but does not appear to affect functional outcomes.(You mean you missed the earlier research I referred to?) Future randomised trials can be conducted outside East Asia, or compare cilostazol with a wider range of antiplatelet agents.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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http://dx.doi.org/10.1136/svn-2020-000737

 

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