You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Cilostazol stroke prevention study: A placebo-controlled double-blind trial for secondary prevention of cerebral infarction.
Abstract 1:
Cilostazol , an antiplatelet drug that increases the cyclic adenosine monophosphate ( AMP ) levels in platelets via inhibition of cyclic AMP phosphodiesterase , has been used in chronic arterial occlusive disease . The purpose of the present study was to examine the effects of cilostazol on the recurrence of cerebral infa rct ion using a multicenter , r and omized , placebo-controlled , double-blind clinical trial method . Patients who suffered from cerebral infa rct ion at 1 to 6 months before the trial were enrolled between April 1992 and March 1996 . Oral administration of cilostazol ( 100 mg twice daily ) or placebo was r and omly assigned to the patients and continued until February 1997 . The primary endpoint was the recurrence of cerebral infa rct ion . In total , 1,095 patients were enrolled . An analysis based on 1,052 eligible patients ( 526 given cilostazol  and 526 given  placebo )  showed that the cilostazol treatment achieved a significant relative-risk reduction ( 41.7 % ; confidence interval [ CI ] , 9.2 % to 62.5 % ) in the recurrence of cerebral infa rct ion as compared with the placebo treatment ( P=.0150 ) . Intention-to-treat analysis of 1,067 patients also showed a significant relative-risk reduction ( 42.3 % ; CI , 10.3 % to 62.9 % , P=.0127 ) . No clinical ly significant adverse drug reactions of cilostazol were encountered . Long-term administration of cilostazol was effective and safe in the secondary prevention of cerebral infa rct ion


Title 2:
Activation of tyrosine hydroxylase prevents pneumonia in a rat chronic cerebral hypoperfusion model
Abstract 2:
Pneumonia is a common complication with the highest attributable proportion of deaths in patients with stroke .  Cilostazol is a potent type III phosphodiesterase inhibitor , approved as an anti-platelet aggregation agent . The present study was design ed to determine the protective mechanism of cilostazol against post-stroke pneumonia using a rat chronic cerebral hypoperfusion model . Rats were subjected to bilateral common carotid artery ligation ( LBCCA ) and divided r and omly into the vehicle  group ( n=72 ) and cilostazol  group ( n=72 ) . Rats of each group were sacrificed at baseline and at days 14 , 28 and 42 after LBCCA . Cilostazol significantly improved the swallowing reflex by shortening the latency to elicited swallowing and increasing the numbers of swallows ( P<0.05 ) at 14 days of hypoperfusion . It also decreased the numbers of bacterial colonies grown in cultures from homogenized lungs . Cilostazol markedly upregulated cyclic AMP responsive element binding protein ( CREB ) phosphorylation , increased tyrosine hydroxylase ( TH ) expression in the substantial nigra , and maintained dopamine ( 84.7+/-2.3 vs. 79.2+/-4.1 % control ; P=0.0512 ) and substance P levels ( 86.6+/-7.9 vs. 73.9+/-6.5 % control ; P<0.05 ) in the striatum , compared with the vehicle group . Our results indicate that cilostazol improves the swallowing reflex by enhancing the expression of TH through the CREB phosphorylation signaling pathway , and suggest that cilostazol could be useful in preventing pneumonia in the chronic stage of stroke
Moreover , in the two trials , cilostazol could have reduced the incidence of pneumonia via a reduction of the recurrence of cerebral infa rct ion , which suggests that other antiplatelets could also have the same effects .