Efficacy and safety of tirofiban in patients with acute ischemic stroke without large-vessel occlusion and not receiving intravenous thrombolysis: A randomized controlled open-label trial

• Published in: Journal of Neurorestoratology Vol. 10; no. 4; p. 100026
• Main Authors: Yu, Yongpeng, Zheng, Yali, Dong, Xia, Qiao, Xiaohong, Tao, Yu
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.12.2022; Elsevier
• Subjects: Cerebral infarction; Effectiveness; Safety; Thrombolysis; Tirofiban; Cerebral infarction; Effectiveness; Safety; Tirofiban; Thrombolysis
• ISSN: 2324-2426; 2324-2426
• DOI: 10.1016/j.jnrt.2022.100026

To investigate the effectiveness and safety of tirofiban in patients with acute ischemic stroke (AIS) without large-vessel occlusions and not receiving intravenous thrombolysis. Overall, 267 cases were included in the study (134 cases in tirofiban group; 133 cases in control group). After admission, patients in the tirofiban group were administered tirofiban for at least 72 h, and aspirin 100 mg and hydroclopidogrel 75 mg were administered 4 h before discontinuation of tirofiban administration. All patients were followed for 3 months, and the National Institutes of Health Stroke Scale (NIHSS) scores on admission, 24 h, and 7 d after treatment, intracerebral hemorrhage transformation within 48 h from stroke onset, and bleeding were assessed. There was no significant difference between both groups in the incidence of non-symptomatic and symptomatic intracranial hemorrhage (sICH), extracranial hemorrhage events, and thrombocytopenia (p > 0.05). There was a significant different between the NIHSS scores at baseline and 7 d after treatment in the tirofiban group (p = 0.043). At 90 d after treatment, the proportion of patients with a good prognosis in the tirofiban group (modified Rankin Scale [mRS] = 0, 1) was higher than that in the control group (p = 0.021). There was no difference in the proportion of patients with a mRS score of 0–2 between the two groups (p > 0.05). Administration of tirofiban for >72 h (72 h–108 h) is safe and can improve the long-term (90 d) prognosis of patients with AIS without large-vessel occlusions and not receiving intravenous thrombolysis.