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Efficacy of Tirofiban combined with oral antiplatelet therapy in progressive ischemic stroke: A systematic review and meta‑analysis

  • Authors:
    • Yi Yu
    • Tianhao Deng
    • Yufen Jiang
    • Jinwen Ge
    • Yingchen Li
  • View Affiliations / Copyright

    Affiliations: Post‑Graduate School, Hunan University of Chinese Medicine, Changsha, Hunan 410208, P.R. China, Department of Oncology, Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (The Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine), Changsha, Hunan 410006, P.R. China, Post‑Graduate School, Hunan University of Chinese Medicine, Changsha, Hunan 410208, P.R. China, Hunan Academy of Chinese Medicine, Changsha, Hunan 410006, P.R. China, Department of Neurology, Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (The Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine), Changsha, Hunan 410006, P.R. China
    Copyright: © Yu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 236
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    Published online on: September 29, 2025
       https://doi.org/10.3892/etm.2025.12987
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Abstract

This meta‑analysis aimed to evaluate the safety and efficacy of combining tirofiban with oral antiplatelet agents in treating patients with progressive ischemic stroke. The investigators searched several databases, including PubMed, Web of Science, the Cochrane Library, CNKI, VIP, WanFang Data and Sinomed. The search was restricted to literature published before May 5, 2025, without any language restrictions. Stata software 17.0 was used to analyze the results and assess risk of bias. A total of 19 studies comprising 3,667 patients were included in the analysis. Furthermore, statistically significant differences (P<0.05) were observed when comparing the tirofiban group and the control group regarding the incidence of achieving a 3‑month modified Rankin scale (mRS) score of 0‑2, the National Institutes of Health Stroke Scale score, the mRS score, activities of daily living, the platelet aggregation rate, the platelet adhesion rate and the effective rate. However, no significant differences (P>0.05) were detected in the risks of intracranial hemorrhage, other systemic hemorrhage, mortality rate and serious adverse events between the two groups. The study was conducted according to the preferred reporting items for systematic reviews and meta‑analyses guidelines and registered with PROSPERO (no. CRD42025633357), and the findings suggested that tirofiban‑augmented antiplatelet regimens safely improve clinical outcomes in progressive cerebral infarction, particularly when combined with dual oral antiplatelet agents.
View Figures

Figure 1

Flow diagram of the study selection.
WOS, Web of Science; CNKI, China National Knowledge
Infrastructure.

Figure 2

Bias risk diagram of 13 randomized
controlled trials analyzed by Cochrane. (A) Risk of bias summary
and (B) risk of bias graph.

Figure 3

Forest plots comparing tirofiban vs.
non-tirofiban therapy. (A) Proportion of patients with mRS scores
0-2 at 3 months. (B) Subgroup analysis of NIHSS scores. (C) NIHSS
score subgroup analysis stratified by tirofiban treatment duration.
(D) mRS scores. mRS, modified Rankin Scale; NHISS, National
Institutes of Health Stroke Scale; ADL, Activities of Daily Living;
1, oral single antiplatelet drug; 2, oral dual antiplatelet drugs;
LC, long course of treatment; SC, short course of treatment; SMD,
standard mean deviation; CI, confidence intervals; OR, odds
ratio.

Figure 4

Forest plots comparing tirofiban
therapy vs. non-tirofiban therapy for (A) ADL score, (B) BI score,
(C) subgroup analysis of PAgR, and (D) subgroup analysis of PAgR
based on tirofiban treatment duration. ADL, Activities of Daily
Living; BI, Barthel Index; PAgR, platelet aggregation rate; 1, oral
single antiplatelet drug; 2, oral dual antiplatelet drugs; LC, long
course of treatment; SC, short course of treatment; SMD, standard
mean deviation; CI, confidence intervals.

Figure 5

Forest plots comparing tirofiban
therapy with non-tirofiban therapy. (A) Subgroup PAdR. (B)
Effective rate. (C) sICH. (D) Other ICH. PAdR, platelet adhesion
rate; sICH, symptomatic intracerebral hemorrhage; ICH, intracranial
hemorrhage; 1, oral single antiplatelet drug; 2, oral dual
antiplatelet drugs; SMD, standard mean deviation; CI, confidence
intervals; OR, odds ratio.

Figure 6

Forest plots for the meta-analysis of
tirofiban vs. control. (A) Mortality rate. (B) Serious adverse
events after treatment. CI, confidence intervals; OR, odds
ratio.

Figure 7

Publication bias. (A) Egger's
regression plot; (B) Begg's regression plot; and (C) funnel plot.
SMD, standardized mean difference; s.e., standard error.
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Copy and paste a formatted citation
Spandidos Publications style
Yu Y, Deng T, Jiang Y, Ge J and Li Y: Efficacy of Tirofiban combined with oral antiplatelet therapy in progressive ischemic stroke: A systematic review and meta‑analysis. Exp Ther Med 30: 236, 2025.
APA
Yu, Y., Deng, T., Jiang, Y., Ge, J., & Li, Y. (2025). Efficacy of Tirofiban combined with oral antiplatelet therapy in progressive ischemic stroke: A systematic review and meta‑analysis. Experimental and Therapeutic Medicine, 30, 236. https://doi.org/10.3892/etm.2025.12987
MLA
Yu, Y., Deng, T., Jiang, Y., Ge, J., Li, Y."Efficacy of Tirofiban combined with oral antiplatelet therapy in progressive ischemic stroke: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 30.6 (2025): 236.
Chicago
Yu, Y., Deng, T., Jiang, Y., Ge, J., Li, Y."Efficacy of Tirofiban combined with oral antiplatelet therapy in progressive ischemic stroke: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 30, no. 6 (2025): 236. https://doi.org/10.3892/etm.2025.12987
Copy and paste a formatted citation
x
Spandidos Publications style
Yu Y, Deng T, Jiang Y, Ge J and Li Y: Efficacy of Tirofiban combined with oral antiplatelet therapy in progressive ischemic stroke: A systematic review and meta‑analysis. Exp Ther Med 30: 236, 2025.
APA
Yu, Y., Deng, T., Jiang, Y., Ge, J., & Li, Y. (2025). Efficacy of Tirofiban combined with oral antiplatelet therapy in progressive ischemic stroke: A systematic review and meta‑analysis. Experimental and Therapeutic Medicine, 30, 236. https://doi.org/10.3892/etm.2025.12987
MLA
Yu, Y., Deng, T., Jiang, Y., Ge, J., Li, Y."Efficacy of Tirofiban combined with oral antiplatelet therapy in progressive ischemic stroke: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 30.6 (2025): 236.
Chicago
Yu, Y., Deng, T., Jiang, Y., Ge, J., Li, Y."Efficacy of Tirofiban combined with oral antiplatelet therapy in progressive ischemic stroke: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 30, no. 6 (2025): 236. https://doi.org/10.3892/etm.2025.12987
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