Evidence map›Paper›PMID 31900544›Full record

SynthesisEuropean journal of clinical pharmacology2020

Tirofiban for acute ischemic stroke: systematic review and meta-analysis.

Jinhong Gong, Jingjing Shang, Hai Yu, Qian Wan, Dan Su, Zhiqiang Sun, Guangjun Liu

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 6 pooled it
4.1field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 6 syntheses or guidelines pooled it, 48 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Jinhong GongDepartment of Pharmacy, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.
Jingjing ShangDepartment of Pharmacy, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.
Hai YuDepartment of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
Qian WanDepartment of Pharmacy, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China.
Dan SuDepartment of Pharmacy, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.
Zhiqiang SunDepartment of Radiotherapy, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, 213003, Jiangsu, China. jungler@sina.cn.ORCID http://orcid.org/0000-0003-1977-5263
Guangjun LiuDepartment of Pharmacy, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China. liugj66@163.com.
Changzhou No.2 People's Hospital · CNFudan University · CNSoochow University · CN

Funding

Changzhou Sci & Tech Program CE20195048Sci & Tech Development Foundation of Nanjing Medical University NMUB2018061
6 · The paper itself

Abstract

backgroundThe safety and efficacy of tirofiban for patients with acute ischemic stroke (AIS) remains controversial. We therefore conducted a systematic review and meta-analysis.

methodsWe searched PubMed, EMBASE, Cochrane Library, Web of Science, and related international clinical trials registries through March 31, 2019, using the terms "tirofiban" and "stroke". All apparently unconfounded randomized controlled trials (RCTs) and cohort studies with two arms comparing treatment with and without tirofiban for AIS were included in this review. Primary outcomes included symptomatic intracranial hemorrhage (sICH), fatal ICH, mortality, and modified Rankin Scale (mRS 0-2) at 3 months.

resultsSeventeen studies including 2914 AIS patients were identified. Pooled results showed that tirofiban treatment in AIS did not increase the risk of sICH (OR, 0.95; 95% CI, 0.71-1.28; p = 0.75) or mortality (OR, 0.80; 95% CI; 0.64-1.02; p = 0.07). However, fatal ICH increased significantly in the tirofiban treatment group (OR, 2.84; 95% CI, 1.38-5.85; p = 0.005), and subgroup analysis showed that tirofiban via intra-arterial (IA) administration was associated with increased risk of fatal ICH (OR, 2.90; 95% CI, 1.12-7.55; p = 0.03), while intravenous (IV) administration was not (OR, 2.75; 95% CI, 0.92-8.20; p = 0.07). In addition, tirofiban showed no obvious improvement in functional outcome (mRS 0-2) (OR, 1.29; 95% CI, 0.97-1.71; p = 0.08).

conclusionTirofiban seems to be safe in systemic treatment and may represent a potential choice for management of AIS. However, intra-arterial administration requires further adequately controlled studies in order to develop an appropriate protocol, similar to that in cardiology.

Indexed as

Brain IschemiaHumansInjections, Intra-ArterialIntracranial HemorrhagesPlatelet Aggregation InhibitorsRandomized Controlled Trials as TopicStrokeTirofibanTreatment OutcomePlatelet Aggregation InhibitorsTirofibanFatal intracranial hemorrhageStrokeSymptomatic intracranial hemorrhageTirofiban

Identifiers

PMID31900544
OpenAlexW2998215100

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.