M Yang1, X Huo1, F Gao1, A Wang2, N Ma1, H Shi3, W Chen4, S Wang5, Y Wang2, Z Miao1. 1. Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 2. Department of Neurology, Beijing Tiantan Hospital, Beijing, China. 3. Department of Neurology, Nanjing No. 1 Hospital, Nanjing, China. 4. Department of Neurology, Zhangzhou City Hospital, Zhangzhou, China. 5. Department of Neurology, First Affiliated Hospital of Jilin University, Jilin, China.
Abstract
BACKGROUND AND PURPOSE: Tirofiban administration during mechanical thrombectomy (MT) remains controversial. The aim was to evaluate the safety and efficacy of a low-dose rescue tirofiban regimen during MT for Chinese acute ischaemic stroke (AIS) patients. METHODS: Patients from the ANGEL study, a multicentric, prospective registry study that included AIS patients who underwent MT owing to proximal large-artery occlusion from June 2015 to December 2017, were collected. The patients were dichotomized into tirofiban and non-tirofiban groups according to whether rescue tirofiban was performed during MT. Safety outcomes [symptomatic intracerebral haemorrhage (sICH), total intracerebral haemorrhage (ICH) and distal embolization] and efficacy outcomes (artery recanalization and functional outcomes at 3-month follow-up) were compared between groups using logistic regression analysis. RESULTS: A total of 662 patients were included in this study, and 230 (34.7%) were in the tirofiban group. No significant differences in safety outcomes on sICH, total ICH and distal embolization and efficacy outcomes on artery recanalization and 3-month functional independence were observed between the tirofiban and non-tirofiban group in the entire cohort or the anterior circulation stroke or posterior circulation stroke patients (P > 0.05 for all groups). However, low-dose rescue tirofiban was significantly correlated with 3-month mortality reduction for posterior circulation stroke patients [adjusted hazard ratio 0.35 (0.14-0.92), P = 0.03]. CONCLUSIONS: Low-dose rescue tirofiban during MT was not associated with increased risk of sICH, ICH and distal embolization for AIS patients, and may be correlated with 3-month mortality reduction for posterior circulation stroke.
BACKGROUND AND PURPOSE:Tirofiban administration during mechanical thrombectomy (MT) remains controversial. The aim was to evaluate the safety and efficacy of a low-dose rescue tirofiban regimen during MT for Chinese acute ischaemic stroke (AIS) patients. METHODS:Patients from the ANGEL study, a multicentric, prospective registry study that included AIS patients who underwent MT owing to proximal large-artery occlusion from June 2015 to December 2017, were collected. The patients were dichotomized into tirofiban and non-tirofiban groups according to whether rescue tirofiban was performed during MT. Safety outcomes [symptomatic intracerebral haemorrhage (sICH), total intracerebral haemorrhage (ICH) and distal embolization] and efficacy outcomes (artery recanalization and functional outcomes at 3-month follow-up) were compared between groups using logistic regression analysis. RESULTS: A total of 662 patients were included in this study, and 230 (34.7%) were in the tirofiban group. No significant differences in safety outcomes on sICH, total ICH and distal embolization and efficacy outcomes on artery recanalization and 3-month functional independence were observed between the tirofiban and non-tirofiban group in the entire cohort or the anterior circulation stroke or posterior circulation strokepatients (P > 0.05 for all groups). However, low-dose rescue tirofiban was significantly correlated with 3-month mortality reduction for posterior circulation strokepatients [adjusted hazard ratio 0.35 (0.14-0.92), P = 0.03]. CONCLUSIONS: Low-dose rescue tirofiban during MT was not associated with increased risk of sICH, ICH and distal embolization for AIS patients, and may be correlated with 3-month mortality reduction for posterior circulation stroke.
Authors: Johannes Kaesmacher; Nuran Abdullayev; Basel Maamari; Tomas Dobrocky; Jan Vynckier; Eike I Piechowiak; Raoul Pop; Daniel Behme; Peter B Sporns; Hanna Styczen; Pekka Virtanen; Lukas Meyer; Thomas R Meinel; Daniel Cantré; Christoph Kabbasch; Volker Maus; Johanna Pekkola; Sebastian Fischer; Anca Hasiu; Alexander Schwarz; Moritz Wildgruber; David J Seiffge; Sönke Langner; Nicolas Martinez-Majander; Alexander Radbruch; Marc Schlamann; Dan Mihoc; Rémy Beaujeux; Daniel Strbian; Jens Fiehler; Pasquale Mordasini; Jan Gralla; Urs Fischer Journal: J Stroke Date: 2021-01-31 Impact factor: 6.967