Abstract WP316: Efficacy and Safety of Usage of Tirofiban for Patients With Acute Ischemic Stroke- A Meta-Analysis

Abstract

Background: Tirofiban, a Glycoprotein IIb/IIIa inhibitor, has been used as an adjunctive therapy (adjunct to alteplase or antiplatelet) for patients with acute ischemic stroke. We aimed to conduct a systematic review and meta-analysis assessing both the efficacy and safety of tirofiban usage in ischemic stroke patients. Methods: We searched PubMED with the terms “tirofiban", and" ischemic stroke". Inclusion criteria were 1) randomized or non-randomized studies with two study arms; 2) inclusion data on mortality and/or symptomatic intracerebral hematoma (sICH); 3) modified Rankin Scale (mRS) used as an outcome measurement at 90 days; and 4) publication in the English language. We extracted data and calculated a summary odds ratio for sICH, mortality, and favorable outcomes (defined as mRS of 0 ≤1). Results: Five studies with 617 subjects suffering acute ischemic stroke were included in the analysis. Three studies included mRS data at 3 months which demonstrated that the trend of non-significant favorable outcomes in the Tirofiban group were non-significant (ORs=1.29; 95% CI=0.55-3.31; P=0.56). Two studies included data on sICH and there was no difference in risk of sICH. (ORs=0.52; 95% CI=0.09-3.-3; p=0.46). Four studies contained data on patients who died after treatment and there was no difference in the risk of mortality (ORs=1.06; 95% CI: 0.28-3.97; p=0.94). Conclusion: Our meta-analysis suggests that Tirofiban as an adjunct therapy to acute ischemic stroke does not increase the risk of sICH or death in stroke patients, but also does not increase the rate of favorable outcomes.