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The Application of Tirofiban in the Endovascular Treatment of Acute Ischemic Stroke: A Meta-Analysis.
- Source :
-
Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] 2021; Vol. 50 (2), pp. 121-131. Date of Electronic Publication: 2021 Jan 05. - Publication Year :
- 2021
-
Abstract
- Objective: The purpose of this meta-analysis is to evaluate the safety and efficacy of tirofiban during endovascular treatment (EVT) for acute ischemic stroke (AIS) patients.<br />Methods: We systematically searched PubMed, Embase, Web of Science, and CENTRAL (Cochrane Central Register of Controlled Trials) databases for randomized controlled trials and cohort studies (published before May 1, 2020; no language restrictions) comparing tirofiban administration to blank control during EVT in patients with AIS. Our primary end points were the 3-month functional outcome, recanalization rate, symptomatic intracerebral hemorrhage, and 3-month mortality.<br />Results: The incidence of 3-month modified Rankin Scale (mRS) 0-2 score of the tirofiban group was higher than that of the control group (odds ratio [OR] = 1.27, 95% CI [1.09, 1.48], p = 0.002) with heterogeneity (I2 = 34%, p = 0.11). Data pooled from the 6 studies describing the details of retriever stent in EVT revealed that tirofiban was associated with higher incidence of 3-month mRS 0-2 score (OR = 1.48, 95% CI [1.11, 1.96], p = 0.007). The recanalization rate was higher in the tirofiban group compared to the control group (OR = 1.66, 95% CI [1.16, 2.39], p = 0.006). There were no statistically significant differences in the incidence of symptomatic intracranial hemorrhage (OR = 0.97, 95% CI [0.73, 1.31], p = 0.86) and intracranial hemorrhage (OR = 1.08, 95% CI [0.59, 1.97], p = 0.80) between tirofiban and non-tirofiban group. Besides, the tirofiban administration was associated with lower mortality (OR = 0.75, 95% CI [0.62, 0.91], p = 0.003).<br />Conclusions: The application of tirofiban in EVT of AIS may improve functional outcomes and reduce mortality at 3 months. Besides, tirofiban does not seem to increase the risk of symptomatic intracranial hemorrhage and intracranial hemorrhage, either in the anterior or posterior circulation stroke.<br /> (© 2021 S. Karger AG, Basel.)
- Subjects :
- Aged
Cerebral Hemorrhage chemically induced
Female
Functional Status
Humans
Ischemic Stroke diagnosis
Ischemic Stroke mortality
Ischemic Stroke physiopathology
Male
Middle Aged
Motor Activity
Platelet Aggregation Inhibitors adverse effects
Randomized Controlled Trials as Topic
Recovery of Function
Risk Assessment
Risk Factors
Time Factors
Tirofiban adverse effects
Treatment Outcome
Endovascular Procedures adverse effects
Ischemic Stroke therapy
Platelet Aggregation Inhibitors therapeutic use
Tirofiban therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1421-9786
- Volume :
- 50
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Cerebrovascular diseases (Basel, Switzerland)
- Publication Type :
- Academic Journal
- Accession number :
- 33401276
- Full Text :
- https://doi.org/10.1159/000512601