SynthesisJournal of thrombosis and thrombolysis2026
Adjunct tirofiban after intravenous thrombolysis in acute ischemic stroke: a GRADE-guided meta-analysis of randomized trials with trial sequential analysis.
Synthesis in Journal of thrombosis and thrombolysis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Safety and efficacy of intravenous tenecteplase in patients with acute ischemic stroke in the extended time window: an updated meta-analysis.European journal of clinical pharmacology · 2026Pooled it
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Early platelet-mediated re-occlusion and microvascular "no-reflow" can blunt the benefits of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS). Tirofiban, a short-acting GP IIb/IIIa inhibitor, may stabilize post-lysis reperfusion. Our analysis assessed the efficacy and safety of adjunct tirofiban after IVT versus IVT alone (alteplase or Tenecteplase) in patients with AIS. We conducted a meta-analysis of randomized controlled trials (RCTs) identified through searches of PubMed, Cochrane, Scopus, and Web of Science up to August 2025. Dichotomous outcomes were pooled as risk ratios (RRs), and continuous outcomes as mean differences (MDs), each with 95% confidence intervals (CIs). Three RCTs with 1,132 patients were included. Tirofiban improved excellent outcome (64.09% vs. 54.24%, RR 1.19, 95% CI 1.07 to 1.33, P = 0.002) and functional independence (80.67% vs. 70.45%, RR 1.20, 95% CI 1.04 to 1.38, P = 0.01) and reduced poor outcome (19.32% vs. 29.54%, RR 0.61, 95% CI 0.46 to 0.81, P = 0.0006). Early neurologic improvement favored tirofiban at 24-72 h (p = 0.001) but was neutral at 5-7 days (p = 0.25). Safety did not differ for any intracranial hemorrhage (ICH) (p = 0.26), asymptomatic ICH (p = 0.75), symptomatic ICH (p = 0.68), systemic bleeding (p = 0.75), or 90-day mortality (p = 0.84). Across randomized trials, adjunct tirofiban after IVT improved 90-day functional outcomes and early neurologic recovery. For safety, no statistically significant differences were observed in any ICH, asymptomatic ICH, systemic bleeding, or 90-day mortality; however, the estimate for sICH was very imprecise and does not exclude a clinically important increase. These results are exploratory and warrant confirmation in larger, multinational RCTs before informing practice.
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Identifiers
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Registered trials
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.