Evidence map›Paper›PMID 37798430›Full record

ArticleCardiovascular and interventional radiology2024

The Efficacy and Safety of Tirofiban Use in Endovascular Thrombectomy for Intravenous Thrombolysis Applicable Patients with Large Vessel Occlusion Stroke-a Post Hoc Analysis from the Direct-MT Trial.

Yingying Zhang, Ping Zhang, Anyang Tao, Xinliang Wang, Jiangxian Ying, Zhimin Wang, Pengfei Yang, Yongwei Zhang, Lei Zhang, Zifu Li and 4 more

Open access · hybridAbstract read
In one paragraph

Article in Cardiovascular and interventional radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 14% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
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

14 authors at 4 institutions in 1 country.

Yingying Zhang *Department of Neurology, Fudan University Zhongshan Hospital, Shanghai, China.
Ping Zhang *Department of Neurovascular Center, Naval Medical University Changhai Hospital, Shanghai, China.
Anyang Tao *Department of Neurology, Taizhou First People's Hospital, 218 Hengjie Road, Taizhou, 318020, Zhejiang, China.
Xinliang WangDepartment of Neurology, Taizhou First People's Hospital, 218 Hengjie Road, Taizhou, 318020, Zhejiang, China.
Jiangxian YingDepartment of Neurology, Taizhou First People's Hospital, 218 Hengjie Road, Taizhou, 318020, Zhejiang, China.
Zhimin WangDepartment of Neurology, Taizhou First People's Hospital, 218 Hengjie Road, Taizhou, 318020, Zhejiang, China.
Pengfei YangDepartment of Neurovascular Center, Naval Medical University Changhai Hospital, Shanghai, China.
Yongwei ZhangDepartment of Neurovascular Center, Naval Medical University Changhai Hospital, Shanghai, China.
Lei ZhangDepartment of Neurovascular Center, Naval Medical University Changhai Hospital, Shanghai, China.
Zifu LiDepartment of Neurovascular Center, Naval Medical University Changhai Hospital, Shanghai, China.
Meng ZhangDepartment of Neurosurgery, Liaocheng People's Hospital of Shandong First Medical University, 67 West Dongchang Road, Liaocheng, 252200, Shandong, China. 13406399660@126.com.
Chenghua XuDepartment of Neurology, Taizhou First People's Hospital, 218 Hengjie Road, Taizhou, 318020, Zhejiang, China. samuel5098@163.com.ORCID http://orcid.org/0000-0002-4948-6844
Jianmin LiuDepartment of Neurovascular Center, Naval Medical University Changhai Hospital, Shanghai, China.
Direct-MT Investigators
Second Military Medical University · CNTaizhou First People's Hospital · CNSun Yat-sen University · CNLiaocheng People's Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of the study was to evaluate the efficacy and safety of tirofiban use in endovascular thrombectomy for intravenous thrombolysis applicable patients of large vessel occlusion stroke with data from Direct-MT trial. MATERIALS AND

methodsDirect-MT was the first randomized controlled trial to prove the non-inferiority of thrombectomy alone to bridging therapy (intravenous thrombolysis before thrombectomy) for large vessel occlusion stroke. Patients who underwent endovascular procedure were included and divided into thrombectomy-alone group and bridging therapy group. The effect of tirofiban use on 90 days MRS distribution, MRS 0-2 and mortality, successful reperfusion, the ASPECTS and outcome lesion volume of index stroke, re-occlusion of the treated vessel, futile recanalization and safety outcomes were further evaluated in both groups after adjustment for relevant confounding factors. The interaction between tirofiban and rt-PA was also assessed.

resultsOf 639 patients included in this analysis, 180 patients underwent thrombectomy with tirofiban use (28.2%). Patients with tirofiban use had lower percentage of bridging therapy (41.1% vs 54.3%, P = 0.003), higher proportion of large artery atherosclerosis (P < 0.001) and more emergent stenting (30.56% vs 6.97%, P < 0.001). After adjustment for confounding factors, the 90-day modified Rankin Scale distribution, successful final recanalization rate, outcome lesion volume of index stroke on CT and intracranial hemorrhage risk showed no difference after tirofiban use in thrombectomy-alone group and in bridging therapy group. No interaction effect between tirofiban and rt-PA was detected.

conclusionBased on data from Direct-MT trial, tirofiban is a safe medication for intravenous thrombolysis applicable patients with large vessel occlusion stroke undergoing thrombectomy. LEVEL OF EVIDENCE: Level 3, cohort study of randomized trial.

Indexed as

Arterial Occlusive DiseasesEndovascular ProceduresIschemic StrokeThrombectomyTirofibanBrain IschemiaCohort StudiesFibrinolytic AgentsHumansRandomized Controlled Trials as TopicStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeFibrinolytic AgentsTirofibanTissue Plasminogen ActivatorAcute ischemic strokeEndovascular thrombectomyIntravenous thrombolysisLarge vessel occlusionTirofiban

Identifiers

PMID37798430
PMCPMC10844137
OpenAlexW4387378862

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.