Efficacy and safety of tirofiban plus recombinant tissue plasminogen activator versus recombinant tissue plasminogen activator alone in acute ischemic stroke patients: a meta-analysis.
Journal of Stroke and Cerebrovascular Diseases · 2024-11-03 · Meta-analysis
Abstract
OBJECTIVE: Tirofiban plus recombinant tissue plasminogen activator (rtPA) shows good efficacy and safety in treating acute ischemic stroke (AIS) patients, but there is a lack of comprehensive assessment. This meta-analysis aimed to compare the efficacy and safety of rtPA plus tirofiban with rtPA alone in AIS patients. METHODS: This meta-analysis retrieved studies comparing rtPA intravenous thrombolysis followed by tirofiban (rtPA+T group) versus rtPA intravenous thrombolysis alone (rtPA group) for AIS patients in Excerpt Medica Database, Web of Science, Cochrane, PubMed, China National Knowledge Infrastructure, Wanfang, and SinoMed until March 2024. RESULTS: Twenty studies with 2048 AIS patients were enrolled in this meta-analysis. National Institute of Health stroke scale (NIHSS) score after treatment was lower in the rtPA+T group than the rtPA group [standardized mean differences (SMD)=-1.41; 95 % confidence interval (CI)=-1.83, -0.98; P<0.001]. The proportion of AIS patients achieving a favorable functional outcome (modified Rankin Scale score ≤2) was increased in the rtPA+T group versus the rtPA group [relative risk (RR)=1.13; 95 % CI=1.05, 1.21; P=0.001]. The incidence of re-occlusion was lower in the rtPA+T group than in the rtPA group (RR=0.24; 95 % CI=0.10, 0.59; P=0.002), but the incidence of intracranial hemorrhage (ICH) (RR=0.85; 95 % CI=0.51, 1.43), symptomatic ICH (RR=1.10; 95 % CI=0.43, 2.84), and mortality (RR=1.39; 95 % CI=0.53, 3.65) was not different between the two groups (all P>0.05). The stability assessed by sensitivity analysis was good, and no publication bias was found. CONCLUSION: rtPA plus tirofiban achieves superior efficacy with comparable safety profiles compared to rtPA alone in AIS patients.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Antithrombotics & thrombolytics · Thrombolytics · Mortality & survival · Quality of life & function · GP IIb/IIIa inhibitors
Related articles
- Efficacy and safety of adjuvant tirofiban versus intravenous thrombolysis alone in acute ischemic stroke: an updated meta-analysis of randomized controlled trials. (J Thromb Thrombolysis, 2026)
- Efficacy and safety of tirofiban combined with intravenous thrombolysis in Acute ischemic stroke: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials and observational studies. (Neurol Res, 2026)
- Adjunct tirofiban after intravenous thrombolysis in acute ischemic stroke: a GRADE-guided meta-analysis of randomized trials with trial sequential analysis. (J Thromb Thrombolysis, 2026)
- Intravenous Thrombolysis Plus Tirofiban in Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. (J Emerg Med, 2025)
- Tirofiban for Acute Ischemic Stroke Patients Receiving Intravenous Thrombolysis: A Systematic Review and Meta-Analysis. (Cerebrovasc Dis, 2023)
- Early tirofiban administration for patients with acute ischemic stroke treated with intravenous thrombolysis or bridging therapy: Systematic review and meta-analysis. (Clin Neurol Neurosurg, 2022)