Platelet Glycoprotein IIb/IIIa Receptor Inhibitor Tirofiban in Acute Ischemic Stroke

Yang, Ming; Huo, Xiaochuan; Miao, Zhongrong; Wang, Yongjun

doi:10.1007/s40265-019-01078-0

Cited by 70 publications

(72 citation statements)

References 116 publications

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“…The enrolled studies' characteristics and analyzed NOS score are presented in Table 1. According to the administration route of tirofiban [9], the 11 studies can be divided into 2 subgroups: (1) rescue tirofiban: 9 studies used tirofiban during or after endovascular procedures; (2) preoperative tirofiban: 2 [11,15] studies used tirofiban before endovascular procedures.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…However, platelet activation caused by endothelial injuries may lead to thromboembolic complications and give rise to early reocclusion during the operative procedure, [7,8]. Tirofiban, a highly selective glycoprotein (GP) IIb/ IIIa receptor antagonist, which potently inhibits the final pathway of platelet activation, has already been widely used in recent clinical practice to prevent early thrombosis in ET for AIS [9]. However, as an off-label usage, Cerebrovasc Dis 2020;49:442-450 DOI: 10.1159/000509054 whether tirofiban increases the bleeding risk or improves the outcome of ET in AIS is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Safety and Efficacy of Tirofiban in Acute Ischemic Stroke Patients Receiving Endovascular Treatment: A Meta-Analysis

Liu

et al. 2020

Cerebrovasc Dis

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Objectives: Tirofiban is widely used in clinical practice for acute ischemic stroke (AIS). However, whether tirofiban increases the bleeding risk or improves the outcome of AIS patients with endovascular treatment (ET) is unknown. The aim of this meta-analysis is to evaluate the safety and efficacy of tirofiban compared with those without tirofiban in AIS patients receiving ET. Methods: Systematic literature search was done in PubMed and EMBASE databases without language or time limitation. Safety outcomes were symptomatic intracranial hemorrhage (sICH) and mortality. Efficacy outcomes were recanalization rate and favorable functional outcome. Review Manager 5.3 and Stata Software Package 15.0 were used to perform the meta-analysis. Results: Eleven studies with a total of 2,028 patients were included. A total of 704 (34.7%) patients were administrated tirofiban combined with ET. Meta-analysis suggested that tirofiban did not increase the risk of sICH (odds ratio (OR) 1.08; 95% confidence interval (CI) 0.81-1.46; p = 0.59) but significantly decreased mortality (OR 0.68; 95% CI 0.52-0.89; p = 0.005). There was no association between tirofiban and recanalization rate (OR 1.26; 95% CI 0.86-1.82; p = 0.23) or favorable functional outcome (OR 1.21; 95% CI 0.88-1.68; p = 0.24). Subgroup analyses indicated that preoperative tirofiban significantly increase recanalization rate (OR 3.89; 95% CI 1.70-8.93; p = 0.001) and improve favorable functional outcome (OR 2.30; 95% CI 1.15-4.60; p = 0.02). Conclusions: Tirofiban is safe in AIS patients with ET and can significantly reduce mortality; preoperative tirofiban may be effective, but further studies are needed to confirm the efficacy.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Tirofiban in Acute Ischemic Stroke Patients Receiving Endovascular Treatment: A Meta-Analysis

Liu

et al. 2020

Cerebrovasc Dis

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“…32 The drug inhibits platelet aggregation and has been used for treating acute coronary syndrome and is being studied for management of ischemic stroke. 33 In contrast, argatroban is a small molecule that directly inhibits thrombin and is used for management of heparin-induced thrombocytopenia. 34 Piperacillin (Table 1B) by Fluency for ACE2 binding and its precursor glutamine was highly ranked by gene expression DCT, suggesting both deserve further testing to explore potential benefits against SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

Advanced Bioinformatics Rapidly Identifies Existing Therapeutics for Patients with Coronavirus Disease - 2019 (COVID-19)

Kim¹,

Zhang²,

Jin³

et al. 2020

Preprint

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<p>The recent global pandemic has placed a high priority on identifying drugs to prevent or lessen clinical infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused by Coronavirus disease – 2019 (COVID-19). We applied two computational approaches to identify potential therapeutics. First, we sought to identify existing FDA approved drugs that could block coronaviruses from entering cells by binding to ACE2 or TMPRSS2 using a high-throughput AI-based binding affinity prediction platform. Top results included several ACE inhibitors, a beta-lactam antibiotic, two antiviral agents (Fosamprenavir and Emricasan) and glutathione. The platform also assessed specificity for ACE2 over ACE1, important for avoiding counterregulatory effects. Further studies are needed to weigh the benefit of blocking virus entry against potential counterregulatory effects and possible protective effects of ACE2. However, the data herein suggest readily available drugs that warrant experimental evaluation to assess potential benefit. Second, we sought to identify FDA approved drugs that could attenuate the gene expression patterns induced by coronaviruses, using our Disease Cancelling Technology (DCT) platform. DCT was run on an animal model of SARS-CoV, and ranked compounds by their ability to induce gene expression signals that counteract disease-associated signals. Top hits included Vitamin E, ruxolitinib, and glutamine. Glutathione and its precursor glutamine were highly ranked by two independent methods, suggesting both warrant further investigation for potential benefit against SARS-CoV-2. While these findings are not yet ready for clinical translation, this report highlights the potential use of two bioinformatics technologies to rapidly discover existing therapeutic agents that warrant further investigation for established and emerging disease processes.</p>

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“…A detailed description of mechanism, pharmacology, pharmacokinetics, and clinical development of most approved toxin-based drugs can be found in specific reviews already published for each compound (Brogden et al, 1988;Tabacova and Kimmel, 2001;Wong, 2005;Zeymer, 2007;Graetz et al, 2011;Pope and Deer, 2013;Serrano, 2013;Knop et al, 2017;Trujillo and Goldman, 2017;Yang et al, 2019).…”

Section: Approved Drugsmentioning

confidence: 99%

From Animal Poisons and Venoms to Medicines: Achievements, Challenges and Perspectives in Drug Discovery

et al. 2020

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Platelet Glycoprotein IIb/IIIa Receptor Inhibitor Tirofiban in Acute Ischemic Stroke

Cited by 70 publications

References 116 publications

Safety and Efficacy of Tirofiban in Acute Ischemic Stroke Patients Receiving Endovascular Treatment: A Meta-Analysis

Safety and Efficacy of Tirofiban in Acute Ischemic Stroke Patients Receiving Endovascular Treatment: A Meta-Analysis

Advanced Bioinformatics Rapidly Identifies Existing Therapeutics for Patients with Coronavirus Disease - 2019 (COVID-19)

From Animal Poisons and Venoms to Medicines: Achievements, Challenges and Perspectives in Drug Discovery

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