Jin Liu1, Qiuyan Shi2, Yuan Sun3, Jingyuan He4, Bin Yang5, Chunyang Zhang6, Rui Guo7. 1. Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, China. Electronic address: 1904383163@qq.com. 2. Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, China. Electronic address: cnyanqiushi@163.com. 3. Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, China. Electronic address: sunyuandoctor@163.com. 4. Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, China. Electronic address: hjy0ann@163.com. 5. Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, China. Electronic address: 95494157@qq.com. 6. Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, China. Electronic address: zcycycy1979@163.com. 7. Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, China. Electronic address: gr5886@126.com.
Abstract
OBJECTIVE: To evaluate the efficacy of tirofiban administered at different time points within 24 hours of intravenous thrombolysis with alteplase in acute ischemic stroke. METHODS:Patients who underwent intravenous thrombolysis with alteplase and fulfilled other inclusion criteria were randomly divided into 4 groups according to the time points of tirofiban administration: Group A (2 h), Group B (2-12 h), Group C (12-24 h), and Group D (control). The changes in National Institutes of Health Stroke Scale score, modified Rankin Scale score, and adverse events were analyzed. RESULTS: At 7 ± 1 day, the efficacy in Group A was better than that in Group C (P = .006) and Group D (P = .001), but there was no significant difference in the efficacy between Groups A and B (P = .268). Similarly, at 14 ± 2 d, the efficacy in Group A was better than that in Group C (P = .026) and Group D (P = .001), but there was no significant difference in the efficacy between Groups A and B (P = .394). As evaluated by the modified Rankin Scale, the prognosis in Groups A, B, and C was better than that in Group D (P = .042, .008, .027, respectively), which was unrelated to the time points of tirofiban administration. There was no significant difference in the incidence of adverse events among the four groups. CONCLUSIONS:Tirofiban combined with alteplase is effective and safe, and particularly beneficial when administered at 2 hour and 2-12 hours after intravenous thrombolysis with alteplase in acute ischemic stroke.
RCT Entities:
OBJECTIVE: To evaluate the efficacy of tirofiban administered at different time points within 24 hours of intravenous thrombolysis with alteplase in acute ischemic stroke. METHODS:Patients who underwent intravenous thrombolysis with alteplase and fulfilled other inclusion criteria were randomly divided into 4 groups according to the time points of tirofiban administration: Group A (2 h), Group B (2-12 h), Group C (12-24 h), and Group D (control). The changes in National Institutes of Health Stroke Scale score, modified Rankin Scale score, and adverse events were analyzed. RESULTS: At 7 ± 1 day, the efficacy in Group A was better than that in Group C (P = .006) and Group D (P = .001), but there was no significant difference in the efficacy between Groups A and B (P = .268). Similarly, at 14 ± 2 d, the efficacy in Group A was better than that in Group C (P = .026) and Group D (P = .001), but there was no significant difference in the efficacy between Groups A and B (P = .394). As evaluated by the modified Rankin Scale, the prognosis in Groups A, B, and C was better than that in Group D (P = .042, .008, .027, respectively), which was unrelated to the time points of tirofiban administration. There was no significant difference in the incidence of adverse events among the four groups. CONCLUSIONS:Tirofiban combined with alteplase is effective and safe, and particularly beneficial when administered at 2 hour and 2-12 hours after intravenous thrombolysis with alteplase in acute ischemic stroke.
Authors: Yan Zhang; Jianliang Wang; Zhaoxi Ma; Guihua Mu; Da Liang; Yifan Li; Xiaoyan Qian; Luyuan Zhang; Fang Shen; Lei Zhang; Jie Yu; Yang Liu Journal: Front Neurol Date: 2022-10-04 Impact factor: 4.086