Abstract Details

Title Effects of Tirofiban on Functional Outcomes in Patients with Acute Ischemic Stroke Ineligible for Reperfusion Therapy: A Systematic Review and Meta-Analysis of Randomized Studies

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P12 - Poster Session 12 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-008

Objective We conducted a systematic review and meta-analysis to compare intravenous tirofiban versus standard treatment (supportive treatment, acetylsalicylic acid and/or clopidogrel) in acute ischemic stroke patients ineligible for reperfusion therapy.

Background In patients ineligible for reperfusion therapy with intravenous thrombolysis or mechanical thrombectomy, therapeutic options are limited to aspirin and clopidogrel. Tirofiban is a GP-IIb/IIIa inhibitor that could improve functional outcomes in these patients.

Design/Methods We searched PubMed, Embase, and Cochrane from inception to August 2024. The inclusion criteria consisted of randomized studies that compared tirofiban versus standard treatment. Outcomes of interest were 90-day modified Rankin Scale (mRS) 0-1, National Institutes of Health Stroke Scale (NIHSS) score at 7 days, and 90-day all-cause mortality. A random-effects model was used to calculate the risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI). Statistical analysis was performed with R programming language 4.3. The review protocol was registered at PROSPERO (CRD42024587513).

Results We screened 2,182 articles and fully reviewed 14 of them. A total of eight studies, comprising 2,673 patients were included. The use of tirofiban had a higher rate of 90-day mRS 0-1 when compared to standard treatment (RR 1.18; CI 1.03 to 1.37; p = 0.1; I² = 44 %). However, we found no difference between groups in NIHSS at 7 days (MD -1.87; CI -5.89 to 2.15; p < 0.01; I² = 82 %) and 90-day all-cause mortality (RR 1.00; CI 0.41 to 2.45; p < 0.29; I² = 20 %).

Conclusions Tirofiban was associated with better long-term functional outcomes than standard treatment. However, there was no benefit regarding short-term neurologic status or mortality.

Authors/Disclosures
Yuri G. de Souza PRESENTER	Mr. de Souza has nothing to disclose.
Giovanni G. Berton (University of Passo Fundo)	The institution of Mr. Berton has received research support from CRUI-CARE Agreement.
Gabriela D. Carolino	Miss Carolino has nothing to disclose.
Heloisa N. Omuro, Ms	Miss Omuro has nothing to disclose.
Sophia Toscano	Ms. Toscano has nothing to disclose.
Marianna Leite	Miss Leite has nothing to disclose.
Abner Lucas B. De Souza, Sr., MS	Mr. De Souza has nothing to disclose.
Evelyn de d. Pacheco, MD	Dr. Pacheco has nothing to disclose.

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