Lv B, Guo FF, Lin JC, Jing F. Efficacy and safety of argatroban in treatment of acute ischemic stroke: A meta-analysis. World J Clin Cases 2022; 10(2): 585-593 [PMID: 35097084 DOI: 10.12998/wjcc.v10.i2.585]
Corresponding Author of This Article
Feng Jing, MD, Doctor, Department of Neurology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. jfsuccess@126.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 14, 2022; 10(2): 585-593 Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.585
Efficacy and safety of argatroban in treatment of acute ischemic stroke: A meta-analysis
Bin Lv, Fang-Fang Guo, Jia-Cai Lin, Feng Jing
Bin Lv, Feng Jing, Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
Fang-Fang Guo, Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
Jia-Cai Lin, Department of Neurology, Hainan Hospital of Chinese PLA General Hospital, Sanya 572022, Hainan Province, China
Author contributions: Lv B and Guo FF contributed equally to this work; Lv B and Guo FF searched the related articles, analyzed the data, and wrote the manuscript; Lin JC analyzed and interpreted the data; Jing F conceived and designed this study, and made critical revision to the manuscript; all the authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors deny any conflict of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Feng Jing, MD, Doctor, Department of Neurology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. jfsuccess@126.com
Received: June 18, 2021 Peer-review started: June 18, 2021 First decision: September 28, 2021 Revised: October 14, 2021 Accepted: December 2, 2021 Article in press: December 2, 2021 Published online: January 14, 2022
Abstract
BACKGROUND
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.
AIM
To evaluate the efficacy and safety of argatroban for treatment of AIS.
METHODS
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.
RESULTS
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 (c2 = 11.44, I2 = 74%, P = 0.01). Subgroup analysis could not be performed because of the absence of detailed data. The two most recent studies showed acceptable heterogeneity (c2 = 1.56, I2 = 36%, P = 0.21). Our analysis showed that argatroban was not more effective than the control therapy in the acute phase of ischemic stroke (Z = 0.01, P = 0.99). Argatroban did not increase the risk of bleeding compared with the control group (c2 = 0.37, I2 = 0%, P = 0.54, Z = 0.80, P = 0.42).
CONCLUSION
Patients with AIS might not benefit from argatroban and combination therapy with argatroban does not increase bleeding tendency.
Core Tip: This study is the first meta-analysis that systematically assessed the efficacy and safety of argatroban as a cure for acute ischemic stroke (AIS). The results showed that argatroban might not benefit for AIS. Also, this meta-analysis further suggested that argatroban does not increase the risk of bleeding for AIS.
