Cilostazol Administration for Subarachnoid Hemorrhage: A Meta-analysis of Randomized Controlled Trials

Abstract

IntroductionThe efficacy of cilostazol administration to treat subarachnoid hemorrhage remains controversial. We conduct a systematic review and meta-analysis to explore the influence of cilostazol administration on treatment efficacy for subarachnoid hemorrhage.MethodsWe have searched PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases through July 2020 for randomized controlled trials assessing the effect of cilostazol administration in patients with subarachnoid hemorrhage. This meta-analysis is performed using the random-effect model.ResultsFour randomized controlled trials involving 405 patients were included in the meta-analysis. Overall, compared with control group for subarachnoid hemorrhage, cilostazol intervention can significantly reduce symptomatic vasospasm (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.21–0.60; P = 0.0001) and cerebral infarction (OR, 0.40; 95% CI, 0.22–0.73; P = 0.003) and improve no or mild angiographic vasospasm (OR, 2.01; 95% CI, 1.19–3.42; P = 0.01) and an mRS score of 2 or less (OR, 2.70; 95% CI, 1.09–6.71; P = 0.03), but revealed no obvious influence on severe angiographic vasospasm (OR, 0.53; 95% CI, 0.27–1.02; P = 0.06). There were no increase in adverse events (OR, 1.17; 95% CI, 0.54–2.52; P = 0.69), hemorrhagic events (OR, 0.62; 95% CI, 0.06–6.27; P = 0.69), and cardiac events (OR, 2.14; 95% CI, 0.44–10.27; P = 0.34) after the cilostazol intervention than control intervention.ConclusionsCilostazol treatment may be effective to treat subarachnoid hemorrhage in the terms of symptomatic vasospasm, cerebral infarction, no or mild angiographic vasospasm, and an mRS score of 2 or less.

Cilostazol in Cerebral Ischemia and Subarachnoid Hemorrhage: A Promising Agent as Prevention

“…From the trial on human beings, in a recent meta-analysis of four randomized controlled trials, Chen et al [2] were able to show that cilostazol treatment may be effective in treating subarachnoid hemorrhage-in terms of symptomatic vasospasm, cerebral infarction, improved angiographic vasospasm, and modified Rankin Scale of 2 or less-in 405 patients.…”