{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T20:10:01Z","timestamp":1778530201333,"version":"3.51.4"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,8,25]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The latest guidelines do not make clear recommendations on the selection of antiplatelet therapies for long\u2010term secondary prevention of stroke. We aimed to integrate the available evidence to create hierarchies of the comparative efficacy and safety of long\u2010term antiplatelet therapies after ischemic stroke or transient ischemic attack.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We performed a network meta\u2010analysis of randomized controlled trials to compare 11 antiplatelet therapies in patients with ischemic stroke or transient ischemic attack. In December 2014, we searched Medline, Embase, and the Cochrane Library database for trials. The search identified 24 randomized controlled trials including a total of 85\u00a0667 patients with antiplatelet treatments for at least 1\u00a0year. Cilostazol significantly reduced stroke recurrence in comparison with aspirin (odds ratio 0.66, 95% credible interval 0.44 to 0.92) and dipyridamole (odds ratio 0.57, 95% credible interval 0.34 to 0.95), respectively. Cilostazol also significantly reduced intracranial hemorrhage compared with aspirin, clopidogrel, terutroban, ticlopidine, aspirin plus clopidogrel, and aspirin plus dipyridamole. Aspirin plus clopidogrel could not significantly reduce stroke recurrence compared with monotherapies but caused significantly more major bleeding than all monotherapies except terutroban. The pooled estimates did not change materially in the sensitivity analyses of the primary efficacy outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Long\u2010term monotherapy was a better choice than long\u2010term dual therapy, and cilostazol had the best risk\u2013benefit profile for long\u2010term secondary prevention after stroke or transient ischemic attack. More randomized controlled trials in non\u2013East Asian patients are needed to determine whether long\u2010term use of cilostazol is the best option for the prevention of recurrent stroke.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.002259","type":"journal-article","created":{"date-parts":[[2015,8,25]],"date-time":"2015-08-25T01:19:48Z","timestamp":1440465588000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Long\u2010Term Antiplatelet Mono\u2010 and Dual Therapies After Ischemic Stroke or Transient Ischemic Attack: Network Meta\u2010Analysis"],"prefix":"10.1161","volume":"4","author":[{"given":"Wuxiang","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanfan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baoliang","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Rochester Medical Center, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyu","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Columbia University, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61728-0"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61689-4"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61953-4"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.22.2947"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.16.3.406"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.14.1.5"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)09457-3"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70094-2"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2010.00535.x"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70198-8"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68734-5"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(96)00308-5"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000111498"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12264-009-6192-2"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198908243210804"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1159\/000327035"},{"key":"e_1_3_4_19_2","first-page":"146","article-title":"A prospective randomized controlled study on ticlopidine with aspirin for the prevention of ischemic cerebral stroke","volume":"13","author":"Li Y","year":"2000","unstructured":"Li Y, Li D, Wang L, Yu P, Han E, Han D, Ma R, Zhu S, Hu Z, Zhi H, Huang Y, Liu T, Xu L, Liu S, Yuan R. 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