Safety and efficacy of tirofiban combined with endovascular therapy compared with endovascular therapy alone in acute is
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REVIEW
Safety and efficacy of tirofiban combined with endovascular therapy compared with endovascular therapy alone in acute ischemic stroke: a meta-analysis Yingying Sun 1 & Zhen-Ni Guo 1 & Xiuli Yan 1 & Meiqi Wang 1 & Peng Zhang 1 & Haiqiang Qin 2 & Yan Wang 1 & Hongjing Zhu 1 & Yi Yang 1 Received: 30 May 2020 / Accepted: 17 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Endovascular treatment (EVT) has been widely used for treating acute ischemic stroke (AIS). However, the safety and efficacy of treating AIS with tirofiban combined with EVT remain controversial. Therefore, we conducted a meta-analysis to evaluate this treatment. Randomized controlled trials and cohort studies that compared treatment with tirofiban combined with EVT and EVT alone were included in our meta-analysis. Those published from inception to March 31, 2020, were searched using the PubMed, Web of Science, Embase, and Cochrane Library databases. Safety was assessed based on symptomatic intracranial hemorrhage (sICH) incidence and 3-month mortality. Efficacy was assessed based on modified Rankin Scale (mRS) scores at 3 months postEVT and recanalization rates. Data were analyzed using either the random-effects or fixed-effects model based on the heterogeneity of studies. In total, one RCT, six prospective studies, and four retrospective studies (2387 AIS cases) were assessed. Our meta-analysis showed that tirofiban combined with EVT did not increase sICH risk (RR, 1.06; 95%CI, 0.79 to 1.42; P = 0.72) and 3-month mortality (RR, 0.87; 95%CI, 0.74 to 1.04; P = 0.12). Recanalization rates were not significantly different between patients treated with tirofiban combined with EVT and those treated with EVT alone (RR, 1.04; 95%CI, 1.00 to 1.08; P = 0.07), but tirofiban combined with EVT was significantly associated with favorable functional outcomes (mRS score, 0–2) in AIS patients (RR, 1.13; 95%CI, 1.02 to 1.25; P = 0.02). Tirofiban combined with EVT appears to be safe and potentially effective in treating AIS. Keywords Tirofiban . Acute ischemic stroke . Endovascular treatment . Meta-analysis
Introduction Acute ischemic stroke (AIS) is one of the most common causes of disability and death worldwide [1]. Intravenous thrombolysis is considered the most effective therapy for YS and Z-NG contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00234-020-02530-9) contains supplementary material, which is available to authorized users. * Yi Yang [email protected]; [email protected] 1
Neuroscience Center & Clinical Trial and Research Center for Stroke, Department of Neurology, The First Hospital of Jilin University, Xinmin Street, Chang Chun, Jilin 130021, China
2
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
AIS patients within 4.5 h, but endovascular treatment (EVT) may be superior in terms of achieving large artery revascularization, especially beyond the time window of intravenous thrombo
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