A Systemic Review Of Argatroban Used In Acute Ischemic Stroke

Objectives:To assess the efficacy and safety of argatroban used in patients with acute ischemic stroke.Methods:All ramdomized controlled trial and quasi-randomized control trial relating the application of Argatroban used in acute ischemia stroke were searched and included in systemic review. The search and literature review were done by two persons separately with the conducting all the resources such as PUBMED and journal key words match as well as the direct contact and information acquiring from pharmaceutical companies.Meta-analysis was done according to the methods recommended from Cochrane Collaboration and the RevMan5.0 software was applied in data analyses.Results:Total 10 randomized controlled trials and one quasi-randomized controlled trial was selected and 1542 patients were enrolled .Meta-analysis showed that the Argatroban treatment group can significant improve the neurological deficit than placebo group [OR2.40,95%CI(1.65,3.49),P<0.00001]. Improvement of neurological deficit showed a better effectiveness of argatroban than Ozagrel Sodium with statistical significance[OR2.01,95%CI(1.02,3.97),P=0.04]. Improvement of neurological deficit showed a better effectiveness of argatroban than aspirin with statistical significance[OR2.70,95%CI(1.50,4.85), P=0.0009]. Only 2 trials reported that the Intracranial hemorrhage(ICH) was found but the significant statistics difference were not exit between the groups [OR1.68,95%CI(0.34,8.33),P=0.53]. There are 2 trials in experimental controlled trials that mentioned the onset of systemic hemorrhage in patients. However there is not significantly different between groups respectively. Argatroban did not increase the risk and chance of the systemic hemorrhage after given in patients with acute ischemia stroke[OR4.79,95%CI(0.55,42.07),P=0.16].There are 2 trials in Aspirin controlled trials that mentioned the onset of systemic hemorrhage in patients. However there also is not significantly different between groups respectively. Argatroban did not increase the risk and chance of the systemic hemorrhage after given in patients with acute ischemia stroke[OR1.19,95%CI(0.58,2.45),P=0.64].Conclusion:Application of Argatroban may help improve neurological function and daily activity ability as well as reducing the disability in patients post acute ischemia stroke. Promisingly, Argatroban seems like a relative safe to treat the acute ischemia stroke. But the multicenter and large sample randomized controlled trials are still needed.Furthermore, hypothesis of reducing mortality and recurrent in the acute ischemia stroke by Argatroban needs to confirm.