Key result
In acute ischemic stroke, abciximab increased symptomatic intracranial hemorrhage risk (RR 4.26; 95% CI 1.89-9.59), while eptifibatide decreased it (RR 0.17; 95% CI 0.04-0.69).
Why the study?
The safety profile and application coverage of glycoprotein IIb-IIIa inhibitors in stroke-related treatment remained unclear.
Do Glycoprotein IIb-IIIa inhibitors affect the risk of death and intracerebral hemorrhage in patients with acute ischemic stroke?
Population
3700 patients across 20 studies
Comparison
Glycoprotein IIb-IIIa inhibitors (abciximab, eptifibatide, tirofiban) across included studies
Design
Systematic review and meta-analysis of RCTs, prospective, and retrospective studies
Follow-up
90 days
Authors
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Abciximab raises sICH risk while tirofiban/eptifibatide appear safer at low doses; supports drug-specific selection over routine GP IIb-IIIa use in AIS.
Meta-Analysis (n=3,700)
Do Glycoprotein IIb-IIIa inhibitors affect the risk of death and intracerebral hemorrhage in patients with acute ischemic stroke?
Relative Risk: 4.26 (95% CI 1.89–9.59)
In acute ischemic stroke, tirofiban and eptifibatide appear safe at low doses, whereas abciximab significantly increases the risk of symptomatic intracranial hemorrhage.
Zhu et al. (2020) conducted a meta-analysis in acute ischemic stroke (n=3,700). Glycoprotein IIb-IIIa inhibitors was evaluated on death and 90-day intracerebral hemorrhage (ICH) (RR 4.26, 95% CI 1.89-9.59). In acute ischemic stroke, abciximab increased symptomatic intracranial hemorrhage risk (RR 4.26; 95% CI 1.89-9.59), while eptifibatide decreased it (RR 0.17; 95% CI 0.04-0.69).
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