Early intravenous administration of tirofiban is recommended in patients with acute ischemic stroke treated with alteplase:a meta-analysis  

作　　者：Yan-Chao Huo Lu Yang Wen-Jing Zhou Meng Geng Meng Zhang Wen-Bo Zhao Yao-Ming Xu 

机构地区：[1]Graduate School,Inner Mongolia Medical University,Hohhot 010110,China [2]Department of Neurology,Tongliao City Hospital,Tongliao 028000,China [3]Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China

出　　处：《Aging Communications》2023年第1期12-19,共8页衰老通讯

基　　金：supported by the Natural Science Foundation of Inner Mongolia(No.2021MS08169);the Medical and health Science and Technology Project of Inner Mongolia(No.202201571).

摘　　要：Background:The occurrence of early neurological deterioration following intravenous thrombolysis(IVT)is considered a particularly ominous clinical event and is strongly correlated with poor outcomes.Initiating tirofiban within 24 h after IVT has been suggested as a better treatment option to achieve long-term functional outcomes.However,the rationality of this remedy is a controversial.The purpose of the study was to evaluate the safety and efficacy of early intravenous tirofiban administration after IVT in patients with acute ischemic stroke(AIS).Methods:Databases including PubMed,EMBASE,Cochrane Library,and Web of Science were searched for clinical trials on early tirofiban implementation after IVT in patients with AIS from inception to September 2022.Odds ratios(ORs)were generated for dichotomous variants via meta-analysis using STATA 17.0 MP.Results:Five clinical trials with 725 patients were eligible.The study outcomes demonstrated that early tirofiban administration after IVT was not associated with symptomatic intracranial hemorrhage(OR,0.78;95%confidence interval(CI),0.22–2.74;P=0.70),asymptomatic intracranial hemorrhage(OR,1.11;95%CI,0.52–2.37;P=0.80),systemic bleeding(OR,0.97;95%CI,0.42–2.23;P=0.94),and death(OR,1.05;95%CI,0.47–2.31;P=0.91),but may reduce the incidence of early neurological deterioration(OR,0.09;95%CI,0.02–0.50;P=0.01),and was significantly associated with 90-day excellent(modified Rankin scale score 0–1)(OR,2.01;95%CI,1.35–3.02;P=0.00)and favorable(modified Rankin scale score 0–2)(OR,2.30;95%CI,1.63–3.23;P=0.00)functional outcomes.Conclusion:The early intravenous administration of tirofiban after IVT in patients with AIS may be a safe and effective treatment strategy that improves long-term neurological functional outcomes without increasing the risk of adverse events.

关 键 词：acute ischemic stroke tirofiban ALTEPLASE intravenous thrombolysis META-ANALYSIS 

分 类 号：R54[医药卫生—心血管疾病]