Continuous intravenous tirofiban can improve the 90-day functional outcome and decrease 90-day mortality without...

Area of Science:

• Neurology
• Cardiovascular Medicine
• Pharmacology

Background:

• The efficacy of continuous intravenous tirofiban in endovascular therapy for acute ischemic stroke (AIS) remains uncertain.
• This meta-analysis evaluates the 90-day functional prognosis for AIS patients treated with endovascular therapy and intravenous tirofiban.

Purpose of the Study:

• To assess the impact of intravenous tirofiban on functional outcomes in AIS patients receiving endovascular treatment.
• To determine the safety and efficacy of tirofiban in improving mortality, recanalization rates, and hemorrhage complications.

Main Methods:

• A systematic literature search was conducted across PubMed, Embase, and CENTRAL databases.
• Inclusion criteria comprised cohort studies and randomized controlled trials involving AIS patients who underwent endovascular therapy with intravenous tirofiban monotherapy or combination therapy.
• Data on modified Rankin Scale (mRS) at 90 days, mortality, symptomatic intracranial hemorrhage (sICH), intracranial hemorrhage (ICH), and recanalization were analyzed.

Main Results:

• Twelve studies with 3268 AIS participants were analyzed.
• Tirofiban administration was associated with favorable 90-day functional outcomes (mRS) (ORs = 1.36; 95% CI = 1.09-1.70).
• Significant reductions in 90-day mortality (ORs = 0.73; 95% CI:0.59-0.89) and increased recanalization rates (ORs = 1.50; 95% CI:1.08-2.09) were observed, with no significant increase in sICH or ICH rates.

Conclusions:

• Intravenous tirofiban, as monotherapy or following intra-arterial administration, is safe and effective in AIS patients undergoing endovascular therapy.
• The treatment improves 90-day functional outcomes, reduces mortality, and enhances early recanalization.
• No significant increase in symptomatic or overall intracranial hemorrhage rates was found.