Tirofiban significantly increased the likelihood of achieving an mRS score of 0 at 90 days in stroke patients (RR 1.39; 95% CI 1.15-1.69; p=0.0006), though it increased intracranial hemorrhage.
Meta-Analysis (n=2,088)
Does tirofiban improve functional outcomes and safety in stroke patients?
In stroke patients, tirofiban improves functional outcomes at 90 days but is associated with a significantly increased risk of intracranial hemorrhage.
Relative Risk: 1.39 (95% CI 1.15–1.69)
p-value: p=0.0006
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Al‐Salihi et al. (Thu,) conducted a meta-analysis in Stroke (n=2,088). Tirofiban vs. control was evaluated on mRS 0 score after 90 days (RR 1.39, 95% CI 1.15, 1.69, p=0.0006). Tirofiban significantly increased the likelihood of achieving an mRS score of 0 at 90 days in stroke patients (RR 1.39; 95% CI 1.15-1.69; p=0.0006), though it increased intracranial hemorrhage.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: