Full
Outline
At present, the anticoagulant therapy for acute ischemic stroke (AIS) has been controversial. Argatroban, as a relatively safe novel anticoagulant, is widely used in the treatment of AIS. This study aims to systematically summarize the clinical efficacy and safety of argatroban combined with antiplatelet drugs for AIS.
CNKI, WanFang Data, VIP, PubMed, Embase, Web of Science, and the Cochrane Library were searched for randomized controlled trials (RCTs) on argatroban combined with antiplatelet drugs for acute ischemic stroke, with a search period from inception to June 2024. Two researchers independently screened the literature according to inclusion and exclusion criteria, evaluated the quality of the included studies, extracted data. Meta-analysis and subgroup analysis were performed using statistical software.
A total of 40 RCTs involving 3 864 patients were included. Meta-analysis results showed that Argatroban combined with antiplatelet drugs improved clinical efficacy [odds ratio (OR)=3.51, 95% confidence interval (CI) (2.84, 4.32), Z=11.73 (P<0.000 01)], enhanced the ability of daily living [mean difference (MD)=9.81, 95%CI (8.57, 11.05), P<0.000 01], Z=15.54 (P<0.000 01), improved the degree of clinical neurological deficit [MD=-2.55, 95%CI (-2.88, -2.22), Z=15.09 (P<0.000 01)], coagulation parameters showed no significant abnormalities, with activated partial thromboplastin time (APTT) [MD=0.94, 95%CI (-0.29, 2.18), Z=1.50 (P=0.13)], fibrinogen (FIB) [MD=-0.31, 95%CI (-0.92, 0.30), Z=0.99 (P=0.31)], and the risk of adverse reactions was not increased [OR=0.84, 95%CI (0.63, 1.14), Z=1.12 (P=0.26)].
In the current treatment of AIS, the combination of antiplatelet drugs and argatroban can improve the clinical efficacy, enhance daily living ability, restore neurological function, improve prognosis, and potentially reduce disability rate. However, more rigorous and multi-center, large sample and high-quality studies are still needed to provide more objective and systematic evidence regarding the clinical efficacy, bleeding risk, specific dose, and application type of argatroban in stroke.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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