The Application of Tirofiban in the Endovascular Treatment of Acute Ischemic Stroke: A Meta-Analysis

被引：51

作者：

Tang, Lisha ^{[1
]}

Tang, Xiangqi ^{[1
]}

Yang, Qianwen ^{[1
]}

机构：

[1] Cent South Univ, Xiangya Hosp 2, Dept Neurol, Renmin Rd 139, Changsha 410011, Peoples R China

来源：

CEREBROVASCULAR DISEASES | 2021年 / 50卷 / 02期

关键词：

Tirofiban; Acute ischemic stroke; Endovascular treatment; MECHANICAL THROMBECTOMY; SAFETY; EFFICACY; THROMBOLYSIS; ALTEPLASE; THERAPY; RISK;

D O I：

10.1159/000512601

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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. 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. 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 (I-2 = 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). 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. (c) 2021 S. Karger AG, Basel

引用

页码：121 / 131

页数：11

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