{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:16:49Z","timestamp":1790709409769,"version":"4.1.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,3,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Although antiplatelet agents are frequently prescribed in moyamoya disease in routine clinical practice, there are no large\u2010scale epidemiologic trials or randomized trial evidence to support their use in patients with moyamoya disease.<\/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\">Using the Korean National Health Insurance Service database, patients diagnosed with moyamoya disease between 2002 and 2016 were followed up for up to 14\u00a0years to assess, using time\u2010dependent Cox regression in all patients and in a propensity score\u2013matched cohort, the association of antiplatelet therapy and individual antiplatelet agents with survival. Among 25\u00a0978 patients with newly diagnosed moyamoya disease, mean age was 37.6\u00b119.9\u00a0years, 61.6% were women, and total follow\u2010up was 163\u00a0347 person\u2010years. Among 9154 patients who were prescribed antiplatelet agents at least once during the follow\u2010up period, the proportion prescribed cilostazol gradually increased from 5.5% in 2002 to 56.0% in 2016. Any antiplatelet use was associated with reduced risk of death (hazard ratio, 0.77; 95% CI, 0.70\u20130.84) in a multivariate model. Among individual antiplatelet agents, cilostazol was associated with greater reduction in mortality than the 5 other antiplatelet regimens. Subgroup analysis, according to the age group and history of ischemic stroke, and sensitivity analysis, using propensity score\u2013matched analysis, revealed consistent results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Antiplatelet therapy is associated with substantial improvement in survival in patients with moyamoya disease, and cilostazol is associated with greater survival benefit compared with other antiplatelet regimens. These results provisionally support the use of antiplatelet therapy in patients with moyamoya disease and the conduct of confirmatory randomized controlled trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.017701","type":"journal-article","created":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T05:23:45Z","timestamp":1613971425000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":53,"title":["Association of Antiplatelet Therapy, Including Cilostazol, With Improved Survival in Patients With Moyamoya Disease in a Nationwide Study"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4004-8434","authenticated-orcid":false,"given":"Woo\u2010Keun","family":"Seo","sequence":"first","affiliation":[{"name":"Department of Neurology and Stroke Center Samsung Medical Center Seoul Korea"},{"name":"Department of Digital Health Samsung Advanced Institute for Health Sciences &amp; TechnologySungkyunkwan University Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae\u2010Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center Samsung Medical Center Seoul Korea"},{"name":"Department of Digital Health Samsung Advanced Institute for Health Sciences &amp; TechnologySungkyunkwan University Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun\u2010Hyeok","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center Samsung Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye\u2010Sel","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center Samsung Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong\u2010Won","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center Samsung Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9141-2251","authenticated-orcid":false,"given":"Jeffrey L.","family":"Saver","sequence":"additional","affiliation":[{"name":"Department of Digital Health Samsung Advanced Institute for Health Sciences &amp; TechnologySungkyunkwan University Seoul Korea"},{"name":"Department of Neurology University of California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7962-8751","authenticated-orcid":false,"given":"Oh Young","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center Samsung Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyeong\u2010Moon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center Samsung Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.52.245"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009942"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2015.10.003"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30128-5"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30148-6"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70198-8"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.014529"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/01616412.2019.1580455"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2018.07.041"},{"key":"e_1_3_2_11_2","first-page":"799","article-title":"Data resource profile: the national health information database of the National Health Insurance Service in South Korea","volume":"46","author":"Cheol Seong S","year":"2017","unstructured":"Cheol Seong S, Kim YY, Khang YH, Heon Park J, Kang HJ, Lee H, Do CH, Song JS, Hyon Bang J, Ha S, et al. 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