Lv Bin, Guo Fang-Fang, Lin Jia-Cai, Jing Feng
Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China.
Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China.
World J Clin Cases. 2022 Jan 14;10(2):585-593. doi: 10.12998/wjcc.v10.i2.585.
Argatroban is a novel direct thrombin inhibitor that has been used for treatment of acute ischemic stroke (AIS). To our knowledge, no systematic analysis has assessed the efficacy and safety of argatroban for treatment of AIS.
To evaluate the efficacy and safety of argatroban for treatment of AIS.
Cochrane Library, Medline, PubMed, and Web of Science were searched to retrieve all studies associated with argatroban and AIS. Effective rate, adverse events rate, and 95% confidence intervals were calculated and pooled using meta-analysis methodology.
We only found four randomized controlled studies, comprising 354 cases with 213 in the argatroban group and 141 in the control group. Great heterogeneity was found in the four studies ( = 11.44, = 74%, = 0.01). Subgroup analysis could not be performed because of the absence of detailed data. The two most recent studies showed acceptable heterogeneity ( = 1.56, = 36%, = 0.21). Our analysis showed that argatroban was not more effective than the control therapy in the acute phase of ischemic stroke ( = 0.01, = 0.99). Argatroban did not increase the risk of bleeding compared with the control group ( = 0.37, = 0%, = 0.54, = 0.80, = 0.42).
Patients with AIS might not benefit from argatroban and combination therapy with argatroban does not increase bleeding tendency.
阿加曲班是一种新型直接凝血酶抑制剂，已用于治疗急性缺血性卒中（AIS）。据我们所知，尚无系统分析评估阿加曲班治疗AIS的疗效和安全性。
评估阿加曲班治疗AIS的疗效和安全性。
检索Cochrane图书馆、Medline、PubMed和科学网，以获取所有与阿加曲班和AIS相关的研究。采用荟萃分析方法计算并汇总有效率、不良事件发生率及95%置信区间。
我们仅找到四项随机对照研究，共354例患者，其中阿加曲班组213例，对照组141例。四项研究存在较大异质性（I² = 11.44，P = 74%，P = 0.01）。由于缺乏详细数据，无法进行亚组分析。最近的两项研究显示异质性可接受（I² = 1.56，P = 36%，P = 0.21）。我们的分析表明，在缺血性卒中急性期，阿加曲班并不比对照治疗更有效（P = 0.01，RR = 0.99）。与对照组相比，阿加曲班未增加出血风险（P = 0.37，RR = 0%，P = 0.54，RR = 0.80，P = 0.42）。
AIS患者可能无法从阿加曲班中获益，且阿加曲班联合治疗不会增加出血倾向。
