INTRODUCTION The association between the use of cilostazol as a post-stroke antiplatelet medication and a reduction in post-stroke pneumonia has been suggested. However, whether cilostazol has a greater preventive effect against post-stroke aspiration pneumonia (AP) than other antiplatelet medications remains unclear. Thus, this study aimed to evaluate whether cilostazol has a greater preventive effect against post-stroke AP than aspirin or clopidogrel. METHODS Through the Japanese Diagnosis Procedure Combination database, we identified patients who were hospitalized for ischemic stroke between April 2012 and September 2019. We performed 1:1 propensity score matching between patients who received cilostazol alone at discharge and those who received aspirin or clopidogrel alone at discharge. The primary outcome was the 90-day readmission for post-stroke AP. The occurrence of recurrent ischemic stroke within 90 days was also evaluated. RESULTS Among the 305,543 eligible patients with ischemic stroke, 65,141 (21%), 104,157 (34%), and 136,245 (45%) received cilostazol, aspirin, and clopidogrel, respectively. Propensity score matching generated 65,125 pairs. The cilostazol group had a higher proportion of 90-day post-stroke readmissions with AP than the aspirin or clopidogrel groups (1.5% vs. 1.2%, p < 0.001). The proportion of patients with recurrent ischemic stroke within 90 days was also higher in the cilostazol group (2.4% vs. 2.2%, p = 0.017). CONCLUSION The present study suggests that cilostazol may not have a greater effect on preventing post-stroke AP within 90 days than other antiplatelet medications. Nevertheless, further randomized controlled trials with longer follow-up periods are warranted.

中文翻译：

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西洛他唑与阿司匹林或氯吡格雷相比，可减少中风后吸入性肺炎：一项全国回顾性队列研究。

引言 有人提出，使用西洛他唑作为中风后抗血小板药物与减少中风后肺炎之间存在关联。然而，西洛他唑是否比其他抗血小板药物对中风后吸入性肺炎（AP）具有更大的预防作用仍不清楚。因此，本研究旨在评估西洛他唑是否比阿司匹林或氯吡格雷对中风后 AP 具有更大的预防作用。方法 通过日本诊断程序组合数据库，我们确定了 2012 年 4 月至 2019 年 9 月期间因缺血性卒中住院的患者。我们对出院时单独接受西洛他唑治疗的患者与出院时单独接受阿司匹林或氯吡格雷治疗的患者进行了 1:1 倾向评分匹配。释放。主要结局是卒中后 AP 90 天再入院。还评估了 90 天内复发性缺血性中风的发生率。结果 在 305,543 名符合条件的缺血性卒中患者中，分别有 65,141 名（21%）、104,157 名（34%）和 136,245 名（45%）接受了西洛他唑、阿司匹林和氯吡格雷治疗。倾向得分匹配生成了 65,125 对。西洛他唑组中风后 90 天再入院 AP 的比例高于阿司匹林组或氯吡格雷组（1.5% vs. 1.2%，p < 0.001）。西洛他唑组 90 天内复发缺血性卒中的患者比例也较高（2.4% vs. 2.2%，p = 0.017）。结论 本研究表明，西洛他唑在 90 天内预防中风后 AP 的效果可能并不比其他抗血小板药物更大。然而，有必要进行进一步的随机对照试验和更长的随访期。