{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T20:49:22Z","timestamp":1775249362418,"version":"3.50.1"},"reference-count":70,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,2,17]]},"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To examine the comparative efficacy and safety of different antiplatelet regimens in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Systematic review and network meta-analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data sources<\/jats:title>\n                  <jats:p>As on 31 March 2015, all randomised controlled trials that investigated the effects of antiplatelet agents in the long-term (\u22653\u2005months) secondary prevention of non-cardioembolic transient ischaemic attack or ischaemic stroke were searched and identified.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcome measures<\/jats:title>\n                  <jats:p>The primary outcome measure of efficacy was serious vascular events (non-fatal stroke, non-fatal myocardial infarction and vascular death). The outcome measure of safety was any bleeding.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 36 randomised controlled trials (82\u2005144 patients) were included. Network meta-analysis showed that cilostazol was significantly more effective than clopidogrel (OR 0.77, 95% credible interval 0.60\u20130.98) and low-dose (75\u2013162\u2005mg daily) aspirin (0.69, 0.55\u20130.86) in the prevention of serious vascular events. Aspirin (50\u2005mg daily) plus dipyridamole (400\u2005mg daily) and clopidogrel reduced the risk of serious vascular events compared with low-dose aspirin; however, the difference was not statistically significant. Furthermore, low-dose aspirin was as effective as higher daily doses. Cilostazol was associated with a significantly lower bleeding risk than most of the other regimens. Moreover, aspirin plus clopidogrel was associated with significantly more haemorrhagic events than other regimens. Direct comparisons showed similar results as the network meta-analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Cilostazol was significantly more effective than aspirin and clopidogrel alone in the long-term prevention of serious vascular events in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Cilostazol was associated with a significantly lower bleeding risk than low-dose aspirin (75\u2013162\u2005mg daily) and aspirin (50\u2005mg daily) plus dipyridamole (400\u2005mg daily). Low-dose aspirin was as effective as higher daily doses. However, further large, randomised, controlled, head-to-head trials are needed, especially in non-Asian ethnic groups.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-009013","type":"journal-article","created":{"date-parts":[[2016,3,17]],"date-time":"2016-03-17T22:51:26Z","timestamp":1458255086000},"page":"e009013","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Antiplatelet regimens in the long-term secondary prevention of transient ischaemic attack and ischaemic stroke: an updated network meta-analysis"],"prefix":"10.1136","volume":"6","author":[{"given":"Peng-Peng","family":"Niu","sequence":"first","affiliation":[{"name":"Department of Neurology, Neuroscience Center, The First Hospital of Jilin University, Changchun, Jilin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen-Ni","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neuroscience Center, The First Hospital of Jilin University, Changchun, Jilin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neuroscience Center, The First Hospital of Jilin University, Changchun, Jilin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-Qi","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neuroscience Center, The First Hospital of Jilin University, Changchun, Jilin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neuroscience Center, The First Hospital of Jilin University, Changchun, Jilin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,3,17]]},"reference":[{"key":"2025101812475952000_6.3.e009013.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68770-9"},{"key":"2025101812475952000_6.3.e009013.2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000201253.93811.f6"},{"key":"2025101812475952000_6.3.e009013.3","first-page":"1125","article-title":"Secondary stroke prevention: from guidelines to clinical practice","volume":"100","author":"Graham","year":"2008","journal-title":"J Natl Med Assoc"},{"key":"2025101812475952000_6.3.e009013.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7336.S71"},{"key":"2025101812475952000_6.3.e009013.5","doi-asserted-by":"crossref","unstructured":"Costa J , Ferro JM , Matias-Guiu J , et al . 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