Efficacy and Safety of Intravenous Tirofiban in the Management of Patients with Acute Ischemic Stroke Due to Large Artery Atherosclerosis That Had Undergone Endovascular Thrombectomy: A Systematic Review and Meta-Analysis (P2-13.018)

Objective: To assess the safety and efficacy of intravenous tirofiban in AIS patients due to LAA submitted to endovascular treatment. Background: Tirofiban is shown to be effective in acute ischemic stroke (AIS) patients submitted to mechanical thrombectomy. However, there is a lack of evidence on the effects of intravenous tirofiban on endovascular therapy in patients with large artery atherosclerosis (LAA). Design/Methods: Pubmed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science databases were systematically searched for studies that involved tirofiban in AIS caused by LAA. The statistical analysis was performed using Risk Ratio (RR) with 95% confidence intervals and the Mantel-Haenszel method of random-effects model to evaluate both efficacy and safety. Heterogeneity was assessed using I 2 statistics and Cochran Q test. This meta-analysis evaluated a modified Rankin scale (mRS) between 0 and 2, Successful reperfusion, serious intracranial hemorrhage (sICH), and mortality in 90 days. The statistical analyses for this study were performed using R software (version 4.4.1.). Results: A total of 7 studies were analyzed, a total of 2.438 patients were included. In the meta-analysis, the tirofiban group was associated with a higher proportion of patients in mRS 0–2 (RR 1.15; 95% CI 1.03–1.29; I 2 = 0%), it was not different from the No Intravenous tirofiban (IT) group regarding successful reperfusion (RR 1.04; 95% CI 0.97–1.11; I 2 = 70%), as well as it was not different for sICH (RR 0.81; 95% CI 0.51–1.28; I 2 = 32%), although it was associated with a lower mortality in 90 days rate (RR 0.69; 95% CI 0.59–0.81; I 2 = 0%). Conclusions: This meta-analysis underscores the effects of tirofiban. It has been shown to improve functionality and lower mortality rates in this population and to be a reliable medication in this setting. Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff. Disclosure: Mr. Goncalves has nothing to disclose. Dr. Dominici has nothing to disclose. Mr. Fukunaga has nothing to disclose. Miss de Lima Goncalves has nothing to disclose. Miss Silva has nothing to disclose. Mr. De Sousa Marinho Mendes Filho has nothing to disclose. Ms. Ribeiro has nothing to disclose. Dr. Ogasawara has nothing to disclose. Prof. Almeida has nothing to disclose.