Platelet glycoprotein IIb/IIIa antagonists in ischemic stroke patients without endovascular therapy: A meta-analysis.

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Pharmacotherapy Pub Date : 2024-08-01 Epub Date: 2024-07-01 DOI:10.1002/phar.2949
Dongjun Xu, Cheng Yang, Wei Cao, Xinyu Zhang, Shucong Yang, Xuning Shen, Jun Xu, Huijie Yu
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Abstract

Platelet glycoprotein (GP) IIb/IIIa antagonists have been employed in selective patients after endovascular therapy (EVT) for acute ischemic stroke (AIS), yet application in patients without EVT is debated. This meta-analysis of randomized controlled studies on AIS patients without EVT assessed the effectiveness and safety of platelet GP IIb/IIIa antagonists compared with traditional antiplatelet or thrombolysis therapy. Articles were retrieved from databases, including PubMed, Web of Science, EMBASE, and Cochrane. The risk of bias and certainty level of evidence were assessed. Fifteen studies were included. GP IIb/IIIa antagonists increased the proportion of patients with modified Rankin Scale (mRS) 0-1 (odd ratio [OR] 1.37, 95% confidence interval [CI] 1.04-1.81, p = 0.03), mRS 0-2 (OR 1.27, 95% CI 1.12-1.46, p = 0.0004), and Barthel Index (BI) 95-100 (OR 1.25, p = 0.005); decreased the proportion of stroke progression within 5 days (OR 0.66, p = 0.006); and lowered the mean mRS score at 90 days (mean difference [MD] -0.43, p = 0.002) and the National Institute of Health stroke scale score at 7 days (MD -1.64, p < 0.00001) compared with conventional treatment. Proportions of stroke recurrence within 90 days (OR 1.20, p = 0.60), any intracranial hemorrhage (aICH) (OR 1.20, p = 0.12), symptomatic intracranial hemorrhage (sICH) (OR 0.91, p = 0.88), and death (OR 0.87, p = 0.25) had no statistical difference between both groups. This meta-analysis finds that compared with traditional antiplatelet or thrombolysis therapy, GP IIb/IIIa antagonists administered within 24-96 h of ischemic stroke onset significantly improve functional prognosis of patients with AIS not receiving EVT, as indicated by mRS and BI at 90 days, and do not increase the incidence of aICH, sICH, and death.

未接受血管内治疗的缺血性脑卒中患者使用血小板糖蛋白 IIb/IIIa 拮抗剂:荟萃分析。
血小板糖蛋白(GP)IIb/IIIa拮抗剂已被用于急性缺血性脑卒中(AIS)血管内治疗(EVT)后的选择性患者,但在未进行EVT的患者中的应用还存在争议。这项针对未接受 EVT 的 AIS 患者的随机对照研究荟萃分析评估了血小板 GP IIb/IIIa 拮抗剂与传统抗血小板或溶栓疗法相比的有效性和安全性。文章检索自 PubMed、Web of Science、EMBASE 和 Cochrane 等数据库。评估了偏倚风险和证据的确定性水平。共纳入 15 项研究。GP IIb/IIIa 拮抗剂增加了改良 Rankin 量表(mRS)0-1(奇数比 [OR] 1.37,95% 置信区间 [CI] 1.04-1.81,p = 0.03)、mRS 0-2(OR 1.27,95% CI 1.12-1.46,p = 0.0004)和 Barthel 指数(BI)95-100(OR 1.25,p = 0.005);降低 5 天内中风进展的比例(OR 0.66,p = 0.006);降低 90 天时的平均 mRS 评分(平均差 [MD] -0.43,p = 0.002)和 7 天时的美国国立卫生研究院中风量表评分(MD -1.64,p = 0.002)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pharmacotherapy
Pharmacotherapy 医学-药学
CiteScore
7.80
自引率
2.40%
发文量
93
审稿时长
4-8 weeks
期刊介绍: Pharmacotherapy is devoted to publication of original research articles on all aspects of human pharmacology and review articles on drugs and drug therapy. The Editors and Editorial Board invite original research reports on pharmacokinetic, bioavailability, and drug interaction studies, clinical trials, investigations of specific pharmacological properties of drugs, and related topics.
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