Efficacy and safety of argatroban in treatment of acute ischemic stroke: A meta-analysis

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 (c(2 )= 11.44, I(2 )= 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 (c(2 )= 1.56, I(2 )= 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 (c(2 )= 0.37, I(2 )= 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.