Safety and efficacy of tirofiban in the management of stroke: A systematic review and meta-analysis of randomized controlled trials
<h3>Background </h3><p dir="ltr">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 ac...
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2023
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| _version_ | 1864513529539723264 |
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| author | Mohammed Maan Al-Salihi (13105835) |
| author2 | Ali Ayyad (149042) Maryam Sabah Al-Jebur (15920047) Yezan Al-Salihi (17808287) Ram Saha (15920053) Rami Z. Morsi (3561809) Tareq Kass-Hout (12077930) Sami Al Kasab (10839944) Alejandro M. Spiotta (10588571) |
| author2_role | author author author author author author author author |
| author_facet | Mohammed Maan Al-Salihi (13105835) Ali Ayyad (149042) Maryam Sabah Al-Jebur (15920047) Yezan Al-Salihi (17808287) Ram Saha (15920053) Rami Z. Morsi (3561809) Tareq Kass-Hout (12077930) Sami Al Kasab (10839944) Alejandro M. Spiotta (10588571) |
| author_role | author |
| dc.creator.none.fl_str_mv | Mohammed Maan Al-Salihi (13105835) Ali Ayyad (149042) Maryam Sabah Al-Jebur (15920047) Yezan Al-Salihi (17808287) Ram Saha (15920053) Rami Z. Morsi (3561809) Tareq Kass-Hout (12077930) Sami Al Kasab (10839944) Alejandro M. Spiotta (10588571) |
| dc.date.none.fl_str_mv | 2023-09-01T00:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1016/j.clineuro.2023.107867 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Safety_and_efficacy_of_tirofiban_in_the_management_of_stroke_A_systematic_review_and_meta-analysis_of_randomized_controlled_trials/25018772 |
| 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 Clinical sciences Neurosciences Mathematical sciences Statistics Tirofiban Stroke Endovascular therapy Systematic review Meta-analysis |
| dc.title.none.fl_str_mv | Safety and efficacy of tirofiban in the management of stroke: A systematic review and meta-analysis of randomized controlled trials |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background </h3><p dir="ltr">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. </p><h3>Methods </h3><p dir="ltr">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. </p><h3>Results </h3><p dir="ltr">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. </p><h3>Conclusions </h3><p dir="ltr">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.</p><h2>Other Information</h2><p dir="ltr">Published in: Clinical Neurology and Neurosurgery<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/10.1016/j.clineuro.2023.107867" target="_blank">https://dx.doi.org/10.1016/j.clineuro.2023.107867</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_73d7fdbc4584d54545ec8dbbf6f9ee82 |
| identifier_str_mv | 10.1016/j.clineuro.2023.107867 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/25018772 |
| publishDate | 2023 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Safety and efficacy of tirofiban in the management of stroke: A systematic review and meta-analysis of randomized controlled trialsMohammed Maan Al-Salihi (13105835)Ali Ayyad (149042)Maryam Sabah Al-Jebur (15920047)Yezan Al-Salihi (17808287)Ram Saha (15920053)Rami Z. Morsi (3561809)Tareq Kass-Hout (12077930)Sami Al Kasab (10839944)Alejandro M. Spiotta (10588571)Biomedical and clinical sciencesClinical sciencesNeurosciencesMathematical sciencesStatisticsTirofibanStrokeEndovascular therapySystematic reviewMeta-analysis<h3>Background </h3><p dir="ltr">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. </p><h3>Methods </h3><p dir="ltr">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. </p><h3>Results </h3><p dir="ltr">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. </p><h3>Conclusions </h3><p dir="ltr">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.</p><h2>Other Information</h2><p dir="ltr">Published in: Clinical Neurology and Neurosurgery<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/10.1016/j.clineuro.2023.107867" target="_blank">https://dx.doi.org/10.1016/j.clineuro.2023.107867</a></p>2023-09-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.clineuro.2023.107867https://figshare.com/articles/journal_contribution/Safety_and_efficacy_of_tirofiban_in_the_management_of_stroke_A_systematic_review_and_meta-analysis_of_randomized_controlled_trials/25018772CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/250187722023-09-01T00:00:00Z |
| spellingShingle | Safety and efficacy of tirofiban in the management of stroke: A systematic review and meta-analysis of randomized controlled trials Mohammed Maan Al-Salihi (13105835) Biomedical and clinical sciences Clinical sciences Neurosciences Mathematical sciences Statistics Tirofiban Stroke Endovascular therapy Systematic review Meta-analysis |
| status_str | publishedVersion |
| title | Safety and efficacy of tirofiban in the management of stroke: A systematic review and meta-analysis of randomized controlled trials |
| title_full | Safety and efficacy of tirofiban in the management of stroke: A systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Safety and efficacy of tirofiban in the management of stroke: A systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Safety and efficacy of tirofiban in the management of stroke: A systematic review and meta-analysis of randomized controlled trials |
| title_short | Safety and efficacy of tirofiban in the management of stroke: A systematic review and meta-analysis of randomized controlled trials |
| title_sort | Safety and efficacy of tirofiban in the management of stroke: A systematic review and meta-analysis of randomized controlled trials |
| topic | Biomedical and clinical sciences Clinical sciences Neurosciences Mathematical sciences Statistics Tirofiban Stroke Endovascular therapy Systematic review Meta-analysis |