Tirofiban Combination Therapy for Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis

<h3>Introduction</h3><p dir="ltr">Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality globally. Standard antiplatelet therapies, while partially effective, do not fully inhibit all pathways of platelet aggregation, leaving patients at risk of recurre...

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Main Author: Abdullah Bin Kamran (22565237) (author)
Other Authors: Ahmed Bazil Bin Khalil (22565240) (author), Ayesha Muhammad (18702111) (author), Hira Arshad (22565243) (author), Fatima Nazir (22565246) (author), Muhammad Mateen Ali (22565249) (author), M. Mairaj Umar (22565252) (author), Muhammad Farhan (4454434) (author), Sudhair Alam (22565255) (author), Javed Iqbal (2121922) (author)
Published: 2025
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_version_ 1864513533180379136
author Abdullah Bin Kamran (22565237)
author2 Ahmed Bazil Bin Khalil (22565240)
Ayesha Muhammad (18702111)
Hira Arshad (22565243)
Fatima Nazir (22565246)
Muhammad Mateen Ali (22565249)
M. Mairaj Umar (22565252)
Muhammad Farhan (4454434)
Sudhair Alam (22565255)
Javed Iqbal (2121922)
author2_role author
author
author
author
author
author
author
author
author
author_facet Abdullah Bin Kamran (22565237)
Ahmed Bazil Bin Khalil (22565240)
Ayesha Muhammad (18702111)
Hira Arshad (22565243)
Fatima Nazir (22565246)
Muhammad Mateen Ali (22565249)
M. Mairaj Umar (22565252)
Muhammad Farhan (4454434)
Sudhair Alam (22565255)
Javed Iqbal (2121922)
author_role author
dc.creator.none.fl_str_mv Abdullah Bin Kamran (22565237)
Ahmed Bazil Bin Khalil (22565240)
Ayesha Muhammad (18702111)
Hira Arshad (22565243)
Fatima Nazir (22565246)
Muhammad Mateen Ali (22565249)
M. Mairaj Umar (22565252)
Muhammad Farhan (4454434)
Sudhair Alam (22565255)
Javed Iqbal (2121922)
dc.date.none.fl_str_mv 2025-06-10T09:00:00Z
dc.identifier.none.fl_str_mv 10.1002/brb3.70508
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Tirofiban_Combination_Therapy_for_Acute_Ischemic_Stroke_A_Systematic_Review_and_Meta_Analysis/30541157
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Cardiovascular medicine and haematology
Neurosciences
Pharmacology and pharmaceutical sciences
acute ischemic stroke
antiplatelet therapy
dual antiplatelet therapy
neurology,stroke
tirofiban
dc.title.none.fl_str_mv Tirofiban Combination Therapy for Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Introduction</h3><p dir="ltr">Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality globally. Standard antiplatelet therapies, while partially effective, do not fully inhibit all pathways of platelet aggregation, leaving patients at risk of recurrent thrombotic events. Tirofiban, a glycoprotein IIb/IIIa receptor inhibitor, has shown promise as an adjunctive treatment in AIS.</p><h3>Methods</h3><p dir="ltr">A comprehensive search was conducted in PubMed, ClinicalTrials.gov, and Cochrane library from inception to July 2024, following PRISMA guidelines. Inclusion criteria comprised randomized controlled trials (RCTs) and comparative observational studies where tirofiban was used as an adjunct to standard antiplatelet therapy. Primary outcomes included symptomatic intracranial hemorrhage (sICH) and favorable modified Rankin scale (mRS) scores at 90 days. Secondary outcomes included National Institute of Health Stroke Scale (NIHSS) scores and all‐cause mortality. Data was analyzed using Review Manager v5.4.1, with random‐effects models employed for all outcomes.</p><h3>Results</h3><p dir="ltr">Fifteen studies, comprising 4,457 patients, were included. Tirofiban significantly improved the likelihood of achieving favorable mRS scores (OR 1.65, 95% CI [1.29, 2.11], p = 0.0001), with moderate heterogeneity (I<sup>2</sup> = 57%, p = 0.006). Tirofiban also significantly reduced NIHSS scores (MD ‐2.08, 95% CI [‐2.77, ‐1.39], p < 0.00001). There was no significant difference in the incidence of sICH between the tirofiban and control groups.</p><h3>Conclusion</h3><p dir="ltr">Tirofiban as an adjunct to standard antiplatelet therapy in AIS patients significantly improves functional outcomes and reduces neurological impairment without increasing the risk of sICH.</p><h2>Other Information</h2><p dir="ltr">Published in: Brain and Behavior<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/brb3.70508" target="_blank">https://dx.doi.org/10.1002/brb3.70508</a></p>
eu_rights_str_mv openAccess
id Manara2_29dcc6580b0a0bf7f838adc31cf273cb
identifier_str_mv 10.1002/brb3.70508
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/30541157
publishDate 2025
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rights_invalid_str_mv CC BY 4.0
spelling Tirofiban Combination Therapy for Acute Ischemic Stroke: A Systematic Review and Meta‐AnalysisAbdullah Bin Kamran (22565237)Ahmed Bazil Bin Khalil (22565240)Ayesha Muhammad (18702111)Hira Arshad (22565243)Fatima Nazir (22565246)Muhammad Mateen Ali (22565249)M. Mairaj Umar (22565252)Muhammad Farhan (4454434)Sudhair Alam (22565255)Javed Iqbal (2121922)Biomedical and clinical sciencesCardiovascular medicine and haematologyNeurosciencesPharmacology and pharmaceutical sciencesacute ischemic strokeantiplatelet therapydual antiplatelet therapyneurology,stroketirofiban<h3>Introduction</h3><p dir="ltr">Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality globally. Standard antiplatelet therapies, while partially effective, do not fully inhibit all pathways of platelet aggregation, leaving patients at risk of recurrent thrombotic events. Tirofiban, a glycoprotein IIb/IIIa receptor inhibitor, has shown promise as an adjunctive treatment in AIS.</p><h3>Methods</h3><p dir="ltr">A comprehensive search was conducted in PubMed, ClinicalTrials.gov, and Cochrane library from inception to July 2024, following PRISMA guidelines. Inclusion criteria comprised randomized controlled trials (RCTs) and comparative observational studies where tirofiban was used as an adjunct to standard antiplatelet therapy. Primary outcomes included symptomatic intracranial hemorrhage (sICH) and favorable modified Rankin scale (mRS) scores at 90 days. Secondary outcomes included National Institute of Health Stroke Scale (NIHSS) scores and all‐cause mortality. Data was analyzed using Review Manager v5.4.1, with random‐effects models employed for all outcomes.</p><h3>Results</h3><p dir="ltr">Fifteen studies, comprising 4,457 patients, were included. Tirofiban significantly improved the likelihood of achieving favorable mRS scores (OR 1.65, 95% CI [1.29, 2.11], p = 0.0001), with moderate heterogeneity (I<sup>2</sup> = 57%, p = 0.006). Tirofiban also significantly reduced NIHSS scores (MD ‐2.08, 95% CI [‐2.77, ‐1.39], p < 0.00001). There was no significant difference in the incidence of sICH between the tirofiban and control groups.</p><h3>Conclusion</h3><p dir="ltr">Tirofiban as an adjunct to standard antiplatelet therapy in AIS patients significantly improves functional outcomes and reduces neurological impairment without increasing the risk of sICH.</p><h2>Other Information</h2><p dir="ltr">Published in: Brain and Behavior<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/brb3.70508" target="_blank">https://dx.doi.org/10.1002/brb3.70508</a></p>2025-06-10T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1002/brb3.70508https://figshare.com/articles/journal_contribution/Tirofiban_Combination_Therapy_for_Acute_Ischemic_Stroke_A_Systematic_Review_and_Meta_Analysis/30541157CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/305411572025-06-10T09:00:00Z
spellingShingle Tirofiban Combination Therapy for Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis
Abdullah Bin Kamran (22565237)
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Neurosciences
Pharmacology and pharmaceutical sciences
acute ischemic stroke
antiplatelet therapy
dual antiplatelet therapy
neurology,stroke
tirofiban
status_str publishedVersion
title Tirofiban Combination Therapy for Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis
title_full Tirofiban Combination Therapy for Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis
title_fullStr Tirofiban Combination Therapy for Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis
title_full_unstemmed Tirofiban Combination Therapy for Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis
title_short Tirofiban Combination Therapy for Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis
title_sort Tirofiban Combination Therapy for Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis
topic Biomedical and clinical sciences
Cardiovascular medicine and haematology
Neurosciences
Pharmacology and pharmaceutical sciences
acute ischemic stroke
antiplatelet therapy
dual antiplatelet therapy
neurology,stroke
tirofiban