Safety and efficacy of tirofiban in the management of stroke: A systematic review and meta-analysis of randomized controlled trials

替罗非班 医学 科克伦图书馆 荟萃分析 冲程(发动机) 随机对照试验 内科学 入射(几何) 心肌梗塞 机械工程 经皮冠状动脉介入治疗 工程类 物理 光学
作者
Mohammed Maan Al‐Salihi,Ali Ayyad,Maryam Sabah Al-Jebur,Yezan Al-Salihi,Ram Saha,Rami Z. Morsi,Tareq Kass‐Hout,Sami Al Kasab,Alejandro M Spiotta
出处
期刊:Clinical Neurology and Neurosurgery [Elsevier BV]
卷期号:232: 107867-107867 被引量:7
标识
DOI:10.1016/j.clineuro.2023.107867
摘要

About 30 % of stroke patients have experienced unsuccessful reperfusion following endovascular therapy. Mechanical thrombectomy instruments may contribute to this by stimulating platelet aggregation. Tirofiban is a selective and rapidly activated antagonist of the platelets nonpeptide glycoprotein IIb/IIIa receptors that can reversibly suppress platelet aggregation. But, data from the medical literature are conflicting regarding its safety and efficacy for stroke patients. Hence, this study was designed to assess the safety and efficacy of tirofiban in stroke patients.Five major databases (PubMed, Scopus, Web of Science, Embase, and Cochrane library) were searched till December 2022. The Cochrane tool was used for risk of bias assessment, and the RevMan 5.4 was utilized for data analysis.Seven RCTs with 2088 stroke patients were included. Tirofiban significantly increased the number of patients with mRS 0 score after 90 days than control; RR= 1.39, 95 %CI [1.15, 1.69]; p = 0.0006. Additionally, it reduced the NIHSS score after seven days; MD= -0.60, 95 %CI [-1.14, -0.06]; p = 0.03. However, tirofiban increased the incidence of intracranial haemorrhage (ICH); RR= 1.22, 95 %CI [1.03, 1.44]; p = 0.02. Other assessed outcomes showed insignificant results.Tirofiban was associated with a higher mRS 0 score after three months and a lower NIHSS score after seven days. However, it is associated with higher ICH. Multicentric trials are required to provide more convincing proof of its utility.
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