CILOSTAZOL FOR STROKE IN SMALL VESSEL DISEASE : SYSTEMATIC REVIEW OF CURRENT LITERATURE
Journal Title: Mintage journal of pharmaceutical and medical sciences - Year 2018, Vol 7, Issue 8
Abstract
Introduction: Cerebral small vessel disease (SVD) is accounted for 25% of ischemic stroke pathology. Cilostazol is a therapeutic option for secondary ischemic stroke prevention, especially in subgroups with high risks for hemorrhagic events. The available evidence is limited for optimal management of stroke in cerebral SVD. Objective: This systematic review aimed to identify the effectiveness of cilostazole for stroke in SVD Method: This systematic research was done by two authors using mainly PubMed and Cochrane as a database. The terms used to search the literature were “Cilostazol”, “Small Vessel Infarction”, “Lacunar Infarction”, “Ischemic Stroke”, and “Clinical Trial”. We measure the quality of the clinical trials using Jadad Score. If the trial manage to meet the 3 important features then the jadad score of the trial will be 3. Results: The journal from PubMed and Cohrane was up to 3848 journals that were screened. Reviewers then begin to screening on the journals, exclude all of the irrelevant, and duplication study and make sure the inclusion and exclusion criteria were fulfilled. The result was 3 RCT studies. All studies have a good Jadad score. All of the comparison used in the studies is aspirin except for the study of Han, et al. (2014), that compare cilostazol with placebo. All of the subject that were used is above the age of 30 y.o. and the length of treatment is above 3 months. Each of the outcomes in all of the RCT studies is different, but their aims are to measure the effectiveness or the efficacy of cilostazol. Huang, et al (2008) have the most subject (720 subjects) and Lee, et al (2017), have the least subject (80 subjects). Conclusion: Cilostazol is proved to be effective in treating various conditions in ischemic stroke, i.e.: improved endothelial function, restored an inverse correlation between FMD and baseline L-arginine levels, decreased cerebral arterial pulsatility in patients with WMH, increases circulating EPCs and decreases small-dense LDL, reduced MPV, NIHSS, and mRS.
Authors and Affiliations
Rizaldy Taslim Pinzon, Shirley Candra Kurniawan, Rosa De Lima Renita Sanyasi
Keywords
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