Argatroban Combo Improves Functional Recovery in Stroke

TOPLINE:

Argatroban combined with antiplatelet therapy significantly improves functional recovery at 90 days, without increasing the risk for bleeding.

METHODOLOGY:

• While argatroban has been shown to improve neurologic symptoms and daily activities in patients with acute ischemic stroke, it is unclear if combining it with antiplatelet or alteplase thrombolytic treatment in these patients provides additional beneficial.
• Researchers conducted a meta-analysis of 11 studies (three randomized controlled trials and eight retrospective cohort studies), which included 8635 patients with acute stroke, of whom 3999 (46.3%) received argatroban plus antiplatelet or alteplase treatment and 4636 (53.7%) did not receive this treatment (control group).
• The effects of argatroban on the occurrence of hemorrhagic events (any reported bleeding within 90 days) and 90-day functional independence (modified Rankin scale score, 0-2) were evaluated.

TAKEAWAY:

• The argatroban plus antiplatelet therapy group showed a significant improvement in functional recovery at 90 days compared with the control group (risk ratio [RR], 1.09; P
• In contrast, the argatroban plus alteplase group did not show any significant improvement in functional recovery at 90 days compared with the control group (RR, 1.00; P = 0.97).
• Compared with the control group, the argatroban plus antiplatelet therapy or alteplase group did not show a significant increase in the risk for bleeding (RR, 1.07; P =.46).

IN PRACTICE:

“These findings provide valuable insights for clinicians when choosing treatment strategies and highlight the importance of considering patient-specific circumstances, including whether they have received thrombolytic treatment with alteplase,” the researchers wrote.

SOURCE:

The study, led by Haiyan Xie, from The Third Hospital of Quzhou, Quzhou, China, was published online in PLoS One.

LIMITATIONS:

The inclusion of retrospective nonrandomized controlled studies may have introduced selection bias and confounding factors. The study was based on previously published research, which could have introduced publication bias, because studies with negative results are often difficult to publish. 

DISCLOSURES:

This meta-analysis was supported by a grant from the Quzhou City Science and Technology Research Project in 2023.