{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:36:27Z","timestamp":1791765387054,"version":"4.3.4"},"reference-count":16,"publisher":"Japan Atherosclerosis Society","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAT","J Atheroscler Thromb"],"published-print":{"date-parts":[[2026,4,1]]},"DOI":"10.5551\/jat.65901","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T22:07:02Z","timestamp":1764799622000},"page":"441-448","source":"Crossref","is-referenced-by-count":1,"title":["Cilostazol Contributes to Risk Reduction of Stroke Recurrence without Mediating a Reduction of Blood Pressure: Results from CSPS.com"],"prefix":"10.5551","volume":"33","author":[{"given":"Kaori","family":"Miwa","sequence":"first","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Koga","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhiro","family":"Omae","sequence":"additional","affiliation":[{"name":"Department of Data Science, National Cerebral and Cardiovascular Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naruhiko","family":"Kamogawa","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Uchiyama","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Medicine, International University of Health and Welfare, Department of Neurology, Akasaka Sanno Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoki","family":"Hayami","sequence":"additional","affiliation":[{"name":"Department of Data Science, National Cerebral and Cardiovascular Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Shoji","sequence":"additional","affiliation":[{"name":"Department of Data Science, National Cerebral and Cardiovascular Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhiko","family":"Hoshino","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tokyo Saiseikai Central Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Neurological Science, Graduate School of Medicine, Nippon Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Minematsu","sequence":"additional","affiliation":[{"name":"Medical Corporation ISEIKAI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takenori","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunori","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the CSPS.com Trial Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3489","reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"1) Schr\u00f6r K. The pharmacology of cilostazol. Diabetes Obes Metab, 2002; 4 Suppl 2: S14-19.2","DOI":"10.1046\/j.1463-1326.2002.0040s2s14.x"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2) Toyoda K, Uchiyama S, Yamaguchi T, Easton JD, Kimura K, Hoshino H, Sakai N, Okada Y, Tanaka K, Origasa H, Naritomi H, Houkin K, Yamaguchi K, Isobe M, Minematsu K. Dual antiplatelet therapy using cilostazol for secondary prevention in patients with high-risk ischaemic stroke in Japan: a multicentre, open-label, randomised controlled trial. Lancet Neurol, 2019; 18: 539-548","DOI":"10.1016\/S1474-4422(19)30148-6"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3) McHutchison C, Blair GW, Appleton JP, Chappell FM, Doubal F, Bath PM, Wardlaw JM. Cilostazol for Secondary Prevention of Stroke and Cognitive Decline: Systematic Review and Meta-Analysis. Stroke, 2020; 51: 2374-2385","DOI":"10.1161\/STROKEAHA.120.029454"},{"key":"4","doi-asserted-by":"crossref","unstructured":"4) de Havenon A, Sheth KN, Madsen TE, Johnston KC, Turan TN, Toyoda K, Elm JJ, Wardlaw JM, Johnston SC, Williams OA, Shoamanesh A, Lansberg MG. Cilostazol for Secondary Stroke Prevention: History, Evidence, Limitations, and Possibilities. Stroke, 2021; 52: e635-e645","DOI":"10.1161\/STROKEAHA.121.035002"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5) Shi MQ, Su FF, Xu X, Liu XT, Wang HT, Zhang W, Li X, Lian C, Zheng QS, Feng ZC. Cilostazol suppresses angiotensin II-induced apoptosis in endothelial cells. Mol Med Rep, 2016; 13: 2597-2605","DOI":"10.3892\/mmr.2016.4881"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6) Hashimoto A, Miyakoda G, Hirose Y, Mori T. Activation of endothelial nitric oxide synthase by cilostazol via a cAMP\/protein kinase A- and phosphatidylinositol 3-kinase\/Akt-dependent mechanism. Atherosclerosis, 2006; 189: 350-357","DOI":"10.1016\/j.atherosclerosis.2006.01.022"},{"key":"7","doi-asserted-by":"crossref","unstructured":"7) Shattil SJ, Kashiwagi H and Pampori N. Integrin Signaling: The Platelet Paradigm. Blood, 1998; 91: 2645-2657","DOI":"10.1182\/blood.V91.8.2645.2645_2645_2657"},{"key":"8","doi-asserted-by":"crossref","unstructured":"8) Boncoraglio GB, Del Giovane C and Tramacere I. Antihypertensive Drugs for Secondary Prevention After Ischemic Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis. Stroke, 2021; 52: 1974-1982","DOI":"10.1161\/STROKEAHA.120.031945"},{"key":"9","doi-asserted-by":"crossref","unstructured":"9) Toyoda K, Koga M, Tanaka K, Uchiyama S, Sunami H, Omae K, Kimura K, Hoshino H, Fukuda-Doi M, Miwa K, Koge J, Okada Y, Sakai N, Minematsu K, Yamaguchi T. Blood pressure during long-term cilostazol-based dual antiplatelet therapy after stroke: a post hoc analysis of the CSPS.com trial. Hypertens Res, 2024; 47: 2238-2249","DOI":"10.1038\/s41440-024-01742-3"},{"key":"10","doi-asserted-by":"crossref","unstructured":"10) Toyoda K, Uchiyama S, Hoshino H, Kimura K, Origasa H, Naritomi H, Minematsu T. Protocol for Cilostazol Stroke Prevention Study for Antiplatelet Combination (CSPS.com): a randomized, open-label, parallel-group trial. Int J Stroke, 2015; 10: 253-258","DOI":"10.1111\/ijs.12420"},{"key":"11","doi-asserted-by":"crossref","unstructured":"11) Diaz KM, Tanner RM, Falzon L, Levitan EB, Reynolds K, Shimbo D, Muntner P. Visit-to-visit variability of blood pressure and cardiovascular disease and all-cause mortality: a systematic review and meta-analysis. Hypertension, 2014; 64: 965-982","DOI":"10.1161\/HYPERTENSIONAHA.114.03903"},{"key":"12","doi-asserted-by":"crossref","unstructured":"12) Aalen OO, Stensrud MJ, Didelez V, Daniel R, R\u00f8ysland K, Strohmaier S. Time-dependent mediators in survival analysis: Modeling direct and indirect effects with the additive hazards model. Biom J, 2020; 62: 532-549","DOI":"10.1002\/bimj.201800263"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13) Sohn M, Chun EJ and Lim S. Cilostazol treatment for preventing adverse cardiovascular events in patients with type 2 diabetes and coronary atherosclerosis: Long-term follow-up of the ESCAPE study. J Diabetes, 2022; 14: 524-531","DOI":"10.1111\/1753-0407.13300"},{"key":"14","doi-asserted-by":"crossref","unstructured":"14) Kwon SU, Cho YJ, Koo JS, Bae HJ, Lee YS, Hong KS, Lee JH, Kim JS. Cilostazol prevents the progression of the symptomatic intracranial arterial stenosis: the multicenter double-blind placebo-controlled trial of cilostazol in symptomatic intracranial arterial stenosis. Stroke, 2005; 36: 782-786","DOI":"10.1161\/01.STR.0000157667.06542.b7"},{"key":"15","doi-asserted-by":"crossref","unstructured":"15) Sun J, Wang D, Zhao Y, Bai Y, Meng C, Miao G, Liu P. Effects of cilostazol for in-stent restenosis after carotid artery stenting: a meta-analysis. J Cardiothorac Surg, 2025; 20: 275","DOI":"10.1186\/s13019-025-03522-7"},{"key":"16","doi-asserted-by":"crossref","unstructured":"16) Yamaguchi Oura M, Sasaki M, Ohba H, Narumi S, Oura K, Uwano I, Terayama Y. Carotid plaque characteristics on magnetic resonance plaque imaging following long-term cilostazol therapy. J Stroke Cerebrovasc Dis, 2014; 23: 2425-2430","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.05.018"}],"container-title":["Journal of Atherosclerosis and Thrombosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/jat\/33\/4\/33_65901\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T04:25:11Z","timestamp":1775276711000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/jat\/33\/4\/33_65901\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.5551\/jat.65901","relation":{},"ISSN":["1340-3478","1880-3873"],"issn-type":[{"value":"1340-3478","type":"print"},{"value":"1880-3873","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,1]]},"article-number":"65901"}}