Abstract Details

Title Intravenous Thrombolysis Versus Antiplatelet Therapy for Patients with Minor Acute Ischemic Stroke: A Systematic Review and Meta-analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-013

Objective To assess the efficacy and safety of IV-Thrombolysis compared with antiplatelet therapy in patients with minor acute ischemic stroke.

Background Antiplatelet therapy has been the conventional treatment for the management of minor non disabling acute ischemic stroke. However, IV-Thrombolysis has emerged as an adequate alternative for those patients, requiring comprehensive research to assess the efficacy and safety of such strategy.

Design/Methods We performed a systematic review and meta-analysis comparing IV-Thrombolysis (Alteplase) with antiplatelet therapy (dual antiplatelet therapy (DAPT) or Aspirin) in patients with minor acute ischemic stroke. PubMed, Embase, and Cochrane were searched for randomized controlled trials or cohort studies with propensity scores. A random-effects model was used to calculate the risk ratios (RRs) with 95% confidence intervals (CIs). Review Manager 5.4 was used for statistical analysis.

Results A total of four studies comprising 2,499 patients were included, of whom 1,093 (44%) were randomized to IV-Thrombolysis. There was no significant difference between IV-Thrombolysis and DAPT for stroke (RR 1.10; 95%CI 0.67-1.81; p=0.69), modified Rankin Scale (mRS) scores 0-1 (RR 1.00; 95%CI 0.96-1.05; p=0.84), and mRS 0-2 (RR 1.01; 95%CI 0.98-1.03; p=0.62). In addition, there was no significant difference between IV-Thrombolysis and Aspirin for stroke (RR 1.01; 95%CI 0.61-1.69; p=0.96), mortality (RR 0.50; 95%CI 0.08-3.21; p=0.46), mRS scores 0-1 (RR 1.00; 95%CI 0.89-1.13; p=0.95), and mRS 0-2 (RR 1.01; 95%CI 0.97-1.06; p=0.58).

Conclusions In this meta-analysis of patients with minor acute ischemic stroke, IV-Thrombolysis showed efficacy and safety equivalent to antiplatelet therapy with DAPT or Aspirin.

Authors/Disclosures
Marianna Leite PRESENTER	Miss Leite has nothing to disclose.
Lucca Moreira Lopes	No disclosure on file
Eric Pasqualotto	No disclosure on file
Maria Eduarda Souza	Maria Eduarda Souza has nothing to disclose.
Renan Sudo	No disclosure on file
Francisco de Moraes	Francisco de Moraes has nothing to disclose.
Artur Menegaz de Almeida, MS	Mr. Menegaz de Almeida has nothing to disclose.
Victória Siebel	Victória Siebel has nothing to disclose.
Agostinho C. Pinheiro, MD (Mass General Brigham Neurology Residency)	Dr. Pinheiro has nothing to disclose.

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