Evidence map›Paper›PMID 38412157›Full record

SynthesisPloS one2024

Can the combination of antiplatelet or alteplase thrombolytic therapy with argatroban benefit patients suffering from acute stroke? a systematic review, meta-analysis, and meta-regression.

Haiyan Xie, Ying Chen, Wukun Ge, Xiuping Xu, Chengjiang Liu, Zhiyong Lan, Yina Yang

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
  3. Editorial: Reviews in: stroke.Frontiers in neurology · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Haiyan XieDepartment of Clinical Pharmacy, The Third Hospital of Quzhou, Quzhou, Zhejiang, 324003, China.
Ying ChenHangzhou Fuyang District Hospital of Traditional Chinese Medicine, Zhejiang, 311499, China.
Wukun GeDepartment of Clinical Pharmacy, Ninghai First Hospital, Zhejiang, 315600, China.
Xiuping XuDepartment of Emergency Internal Medicine, The Third Hospital of Quzhou, Quzhou, Zhejiang, 324003,China.ORCID 0009-0001-4493-8792
Chengjiang LiuDepartment of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, HeFei, 246000, China.
Zhiyong LanDepartment of Psychiatry Department, The Third Hospital of Quzhou, Quzhou, Zhejiang, 324003, China.
Yina YangDepartment of Neurology, Ninghai First Hospital, Zhejiang, 315600, China.
Quzhou City People's Hospital · CNNinghai County First Hospital · CNAnhui Medical University · CNHangzhou Hospital of Traditional Chinese Medicine · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effectiveness of administering argatroban as a treatment approach following antiplatelet therapy or alteplase thrombolytic therapy in patients with acute stroke is presently uncertain. However, it is important to highlight the potential benefits of combining this medication with known thrombolytics or antiplatelet therapy. One notable advantage of argatroban is its short half-life, which helps minimize excessive anticoagulation and risk of bleeding complications in inadvertent cases of hemorrhagic stroke. By conducting a meticulous review and meta-analysis, we aim to further explore the common use of argatroban and examine the plausible advantages of combining this medication with established thrombolytic and antiplatelet therapies.

methodIn this study, we performed a rigorous and methodical search for both randomized controlled trials and retrospective analyses. Our main objective was to analyze the impact of argatroban on the occurrence of hemorrhagic events and the mRS scores of 0-2. We utilized a meta-analysis to assess the relative risk (RR) associated with using argatroban versus not using it.

resultsIn this study, we analyzed data from 11 different studies, encompassing a total of 8,635 patients. Out of these patients, 3999(46.3%) received argatroban treatment while the remaining 4636(53.7%)did not. The primary outcome of 90-day functional independence (modified Rankin scale (mRS) score≤2) showed that the risk ratio (RR) for patients using argatroban after alteplase thrombolytic therapy compared to those not using argatroban was(RR, 1.00 ([95% CI, 0.92-1.09]; P = 0.97), indicating no statistical significance. However, for patients using argatroban after antiplatelet therapy, was (RR,1.09 [95% CI, 1.04-1.14]; P = 0.0001), which was statistically significant. In terms of hemorrhagic events, the RR for patients using argatroban compared to those not using argatroban was (RR,1.08 [95% CI, 0.88-1.33]; P = 0.46), indicating no statistical significance.

conclusionThe results of this study suggest that further research into combination therapy with argatroban and antiplatelet agents may be warranted, however more rigorous RCTs are needed to definitively evaluate the effects of combination treatment.

Indexed as

ArginineFibrinolytic AgentsPipecolic AcidsPlatelet Aggregation InhibitorsStrokeSulfonamidesThrombolytic TherapyTissue Plasminogen ActivatorDrug Therapy, CombinationHumansargatrobanArginineFibrinolytic AgentsPipecolic AcidsPlatelet Aggregation InhibitorsSulfonamidesTissue Plasminogen Activator

Identifiers

PMID38412157
PMCPMC10898750
OpenAlexW4392189242

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.