The efficacy and safety of tirofiban plus thrombolysis and thrombolysis alone for acute ischemic stroke: A meta-analysis.

INTRODUCTION

Acute ischemic stroke (AIS) is a cerebrovascular disease associated with high disability and mortality. Tirofiban, a platelet glycoprotein IIb/IIIa receptor antagonist, is used in conjunction with thrombolysis for bridging therapy, but its effectiveness and safety compared with thrombolysis alone in patients with stroke are not well-established.

MATERIAL AND

METHODS

PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) from inception to June 17, 2025. Trials reporting the effectiveness and safety of tirofiban bridging after thrombolysis compared with thrombolysis only in patients with acute ischemic stroke were included.

RESULTS

Six RCTs with 1524 participants were included. Tirofiban plus thrombolysis significantly favored improved neurologic function based on both modified Rankin Scale (MRS) 0-2 (Log risk ratio [RR] 0.17; p < 0.001) at day 90. There was no significant difference in symptomatic intracranial hemorrhage (sICH), asymptomatic intracranial hemorrhage(aICH), bleeding from other sites and mortality between the 2 groups (LogRR 0.60; p = 0.21; LogRR -0.04; p = 0.87; LogRR 0.09; p = 0.74; LogRR 0.04; p = 0.90).

CONCLUSIONS

Tirofiban plus thrombolysis was associated with better functional outcomes, but not sICH, aICH, bleeding from other sites, or mortality among patients with AIS compared with thrombolysis only. Further studies should focus on its safety profile and application to target patients.