Abstract 4359641: Use Of Argatroban Plus Antiplatelet Therapy In Patients With Non-Cardioembolic Stroke: A Systematic Review And Meta-Analysis.

The evidence of argatroban and antiplatelet therapy in patients with acute non-cardioembolic stroke ineligible for intravenous thrombolysis or thrombectomy is relatively limited. This meta analysis aimed to evaluate whether argatroban improved efficacy and safety outcomes compared with antiplatelet treatment alone.: A database search was conducted up to April 2025 to identify published trials comparing the use of argatroban plus antiplatelet therapy (experimental group) with antiplatelet therapy alone (control group) in non-cardioembolic stroke. From a total of 186 studies, we included 3 retrospective cohorts and 1 prospective cohort study, encompassing a population of 2,861 patients. The main outcomes assessed included 90-day favorable modified Rankin Scale (mRS) score (0-2), early neurological deterioration (END), change in NIHSS at 7 days, and intracraneal hemorrhage (ICH).: We found that administration of argatroban is associated with a favorable 90-day mRS (RR=1.10, 95%CI: 1.06-1.14, p=<0.00001) and END (RR=0.56 95%CI: 0.32-1.00, P=0.05). No statistically significant difference in change in NIHSS (RR=0.11, 95%CI: -0.50-0.72, P=0.73) and ICH (RR=0.94, 95%CI: 0.56-1.59, P=0.83).: In non-cardioembolic stroke, the use of argatroban in combination with antiplatelet therapy showed better results than antiplatelet therapy alone in terms of functional outcome and prevention of neurological deficit, with no significant increase in intracranial haemorrhage and no change in NIHSS. Further randomised clinical trials are needed to confirm these results.: