Efficacy and safety of argatroban in the management of acute ischemic stroke: A systematic literature review and meta-analysis

阿加曲班 医学 直接凝血酶抑制剂 冲程(发动机) 荟萃分析 溶栓 随机对照试验 组织纤溶酶原激活剂 直接凝血酶抑制剂的发现与发展 内科学 华法林 心肌梗塞 达比加群 凝血酶 心房颤动 工程类 血小板 机械工程
作者
Mohammed Maan Al‐Salihi,Ram Saha,Ali Ayyad,Maryam Sabah Al-Jebur,Yezan Al-Salihi,Anil Roy,Shamser Singh Dalal,Dennis J. Rivet,Alejandro M Spiotta,Adnan I. Qureshi
出处
期刊:Clinical Neurology and Neurosurgery [Elsevier BV]
卷期号:236: 108097-108097 被引量:2
标识
DOI:10.1016/j.clineuro.2023.108097
摘要

Acute ischemic stroke (AIS) is a leading cause of death and disability. AIS is caused by an embolus or thrombus that restricts blood flow to the brain tissue. Despite intravenous thrombolysis and endovascular thrombectomy, a substantial number of patients do not achieve effective reperfusion. Argatroban, a direct thrombin inhibitor, can potentially improve neurological outcomes in AIS patients. However, there are conflicting results in the medical literature regarding the efficacy and safety of argatroban in this context. This study aims to evaluate the efficacy and safety of argatroban as monotherapy or adjunct therapy for acute ischemic stroke. Five major databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) were searched for randomized controlled trials (RCTs) that compared the efficacy and safety of using argatroban alone or in combination with recombinant tissue plasminogen activator (r-TPA) in the management protocol of the AIS. We used Review Manager Software (RevMan 5.4.1) for data analysis. We included 1393 patients from eight RCTs (of them, 726 were treated with argatroban alone or combined with r-TPA, while 667 received the placebo, standard therapy (standard treatments based on current guidelines including antihypertensive, antiplatelet agents, and statins) or endovascular r-TPA). Neither argatroban vs control nor argatroban with r-TPA vs r-TPA showed significant difference regarding the activity in daily living; (SMD= 1.69, 95% CI [−0.23, 3.61]; p = 0.09), (SMD= 0.99, 95% CI [−0.88, 2.86]; p = 0.30), respectively. Also, there was no significant difference in the National Institutes of Health Stroke Scale (NIHSS) score at seven days, the number of patients achieving modified Rankin Scale (mRS) of 0–1 or 0–2 at 90 days (p > 0.05). Argatroban did not significantly increase the risk of adverse events or symptomatic intracranial hemorrhage (ICH), or major systemic bleeding compared to control or r-TPA (p > 0.05) Argatroban does not demonstrate superior efficacy compared to placebo or standard therapy in terms of ADL, NIHSS and mRS outcomes. Importantly, argatroban does not significantly increase the incidence of adverse events, including symptomatic ICH and systemic bleeding.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
fyj完成签到 ,获得积分20
刚刚
zyn发布了新的文献求助10
1秒前
NexusExplorer应助dilli采纳,获得10
1秒前
香蕉君达完成签到,获得积分10
1秒前
zxh656691发布了新的文献求助10
1秒前
默默冬瓜发布了新的文献求助10
2秒前
蓝荆完成签到,获得积分10
2秒前
英俊的铭应助CeciliaLee采纳,获得10
3秒前
3秒前
dong应助肯瑞恩哭哭采纳,获得10
3秒前
小火苗发布了新的文献求助10
4秒前
4秒前
蓝荆发布了新的文献求助10
4秒前
5秒前
6秒前
7秒前
fyj关注了科研通微信公众号
8秒前
8秒前
量子星尘发布了新的文献求助10
8秒前
深海学龙发布了新的文献求助10
9秒前
了一发布了新的文献求助10
9秒前
9秒前
9秒前
9秒前
澡雪发布了新的文献求助10
10秒前
HSA完成签到,获得积分10
13秒前
13秒前
Lord发布了新的文献求助10
13秒前
13秒前
13秒前
是希希啊a发布了新的文献求助10
13秒前
14秒前
郭九九呢完成签到,获得积分10
14秒前
MrRen发布了新的文献求助10
14秒前
地表飞猪应助lizheng采纳,获得50
14秒前
15秒前
无问东西发布了新的文献求助10
16秒前
凯凯凯发布了新的文献求助10
16秒前
LIO完成签到,获得积分10
16秒前
小陈鹿发布了新的文献求助10
17秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Effective Learning and Mental Wellbeing 400
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3976107
求助须知:如何正确求助?哪些是违规求助? 3520330
关于积分的说明 11202435
捐赠科研通 3256819
什么是DOI,文献DOI怎么找? 1798504
邀请新用户注册赠送积分活动 877642
科研通“疑难数据库(出版商)”最低求助积分说明 806496