Wei Li1, Lu Lin1, Meng Zhang2, Ya Wu1, Chengchun Liu1, Xiaoshu Li1, Shuhan Huang1, Chunrong Liang1, Yanjiang Wang1, Jinhua Chen1, Wuwei Feng1. 1. From the Department of Neurology (W.L., L.L., M.Z., Y.W., C.L., X.L., S.H., C.L., Y.W.) and Radiology (J.C.), Research Institute of Surgery, Daping Hospital, Third Military Medical University, China; and Department of Neurology, Medical University of South Carolina (W.F.). 2. From the Department of Neurology (W.L., L.L., M.Z., Y.W., C.L., X.L., S.H., C.L., Y.W.) and Radiology (J.C.), Research Institute of Surgery, Daping Hospital, Third Military Medical University, China; and Department of Neurology, Medical University of South Carolina (W.F.). zhangmeng861@gmail.com.
Abstract
BACKGROUND AND PURPOSE: We investigated whether early initiation of tirofiban, a glycoprotein IIb/IIIa antagonist, is safe, can reduce the risk of reocclusion, and improve outcomes in acute ischemic stroke patients after alteplase. METHODS: Forty-one patients received alteplase followed by intravenous tirofiban infusion for at least 24 hours. The incidence of symptomatic intracranial hemorrhage, systematic bleedings, and death was recorded. The National Institutes of Health stroke scale score was evaluated at 24 hours and at day 7 (or discharge). Modified Rankin scale was assessed at 3 months. Outcomes for these patients were compared with a propensity score-matched historical cohort with alteplase only. RESULTS: The incidence of symptomatic intracranial hemorrhage, death, or systematic bleedings (P=1.00) was not increased in the alteplase/tirofiban group. At 24 hours, fewer patients experienced reocclusion in the alteplase/tirofiban group (2.4% versus 22.0%; P=0.025). At day 7 or discharge, the median National Institutes of Health stroke scale score was significantly lower in the alteplase/tirofiban group (1 versus 6; P=0.002). At 3 months, more patients had favorable outcomes of modified Rankin scale 0 to 1 (70.7% versus 46.2%; P=0.026). CONCLUSIONS: Intravenous tirofiban immediately after alteplase seems to be safe and potentially more effective when compared with alteplase alone for selected stroke patients. CLINICAL TRIAL REGISTRATION: URL: http://www.chictr.org.cn/. Unique identifier: ChiCTR-TRC-14004630.
BACKGROUND AND PURPOSE: We investigated whether early initiation of tirofiban, a glycoprotein IIb/IIIa antagonist, is safe, can reduce the risk of reocclusion, and improve outcomes in acute ischemic strokepatients after alteplase. METHODS: Forty-one patients received alteplase followed by intravenous tirofiban infusion for at least 24 hours. The incidence of symptomatic intracranial hemorrhage, systematic bleedings, and death was recorded. The National Institutes of Health stroke scale score was evaluated at 24 hours and at day 7 (or discharge). Modified Rankin scale was assessed at 3 months. Outcomes for these patients were compared with a propensity score-matched historical cohort with alteplase only. RESULTS: The incidence of symptomatic intracranial hemorrhage, death, or systematic bleedings (P=1.00) was not increased in the alteplase/tirofiban group. At 24 hours, fewer patients experienced reocclusion in the alteplase/tirofiban group (2.4% versus 22.0%; P=0.025). At day 7 or discharge, the median National Institutes of Health stroke scale score was significantly lower in the alteplase/tirofiban group (1 versus 6; P=0.002). At 3 months, more patients had favorable outcomes of modified Rankin scale 0 to 1 (70.7% versus 46.2%; P=0.026). CONCLUSIONS: Intravenous tirofiban immediately after alteplase seems to be safe and potentially more effective when compared with alteplase alone for selected strokepatients. CLINICAL TRIAL REGISTRATION: URL: http://www.chictr.org.cn/. Unique identifier: ChiCTR-TRC-14004630.
Authors: Philipp Gruber; Martin Hlavica; Jatta Berberat; Benjamin Victor Ineichen; Michael Diepers; Krassen Nedeltchev; Timo Kahles; Luca Remonda Journal: Interv Neuroradiol Date: 2018-11-04 Impact factor: 1.610
Authors: Sara Martinez de Lizarrondo; Clément Gakuba; Bradley A Herbig; Yohann Repessé; Carine Ali; Cécile V Denis; Peter J Lenting; Emmanuel Touzé; Scott L Diamond; Denis Vivien; Maxime Gauberti Journal: Circulation Date: 2017-05-09 Impact factor: 29.690
Authors: Eivind Berge; William Whiteley; Heinrich Audebert; Gian Marco De Marchis; Ana Catarina Fonseca; Chiara Padiglioni; Natalia Pérez de la Ossa; Daniel Strbian; Georgios Tsivgoulis; Guillaume Turc Journal: Eur Stroke J Date: 2021-02-19