Korean J Stroke.
2012 Apr;14(1):1-5.
Antiplatelet Therapy for Secondary Stroke Prevention: 2012 Focused Update of Korean Clinical Practice Guidelines for Stroke
- Affiliations
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- 1Department of Neurology, Seoul Medical Center, Seoul, Korea.
- 2Department of Neurology, Soonchunhyang University College of Medicine, Cheonan, Korea.
- 3Department of Neurology, Hallym University College of Medicine, Anyang, Korea. ykh1030@hallym.ac.kr
- 4Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
- 5Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
- 6Department of Neurology, University of Ulsan College of Medicine, Seoul, Korea.
- 7Department of Neurology, Inha University College of Medicine, Incheon, Korea.
- 8Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
- 9Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
- 10Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
Abstract
- Writing Committee of Korean clinical practice guidelines for secondary prevention of stroke has reviewed recent randomized controlled trials of cilostazol published after the first edition of Korean clinical practice guidelines that considered evidences published before June 2007. Two clinical trials and 1 meta-analysis which compared cilostazol directly with aspirin in the prevention of stroke in patients with cerebral infarction or transient ischemic attack (TIA) were identified and included for the current guideline update. Review of findings indicates that cilostazol as compared to aspirin achieved a greater reduction of stroke as well as composite vascular events of stroke, myocardial infarction, and vascular death. For safety, cilostazol was associated with fewer major bleeding events than aspirin. Accordingly, new recommendations for cilostazol are made for prevention of stroke in the setting of noncardioembolic stroke or TIA. Changes in the guidelines necessitated by new evidences will be continuously reflected in future guidelines.
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