Renal function affects the safety and efficacy of tirofiban in acute ischemic stroke thrombectomy patients.

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY Interventional Neuroradiology Pub Date : 2024-05-31 DOI:10.1177/15910199241256682

Linan Qiu, Ye Zhang, Dandan Geng, Yuesong Pan, Xueqian Xu, Jiahao Chen, Minjie Xu, Liuzhu Chen, Yujie Tu, Yezhi Huang, Jingfang Long, Qi Duan, Beilan Wu, Huihua Qiu, Jincai He

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Abstract

Background: Acute ischemic stroke poses a significant health threat, and thrombectomy has become a routine treatment. Tirofiban has emerged as a promising adjunct therapy to minimize reocclusion after thrombectomy. We aimed to investigate whether renal function influences the safety and efficacy of tirofiban in patients undergoing endovascular therapy.

Methods: Patients' clinical data collected from the stroke unit were analyzed. The modified Rankin scale score and symptomatic intracranial hemorrhage (sICH) were used as outcome measures.

Results: A total of 409 patients (mean age: 66.5 years, 292 males [71.4%]) were included. Tirofiban significantly improved 3-month functional outcomes (adjusted odds ratio [aOR] = 2.408, 95% confidence interval [CI] 1.120-5.175), reduced 3-month mortality (aOR = 0.364, 95% CI 0.155-0.856), and decreased the incidence of sICH (aOR = 0.339, 95% CI 0.149-0.767) in patients with estimated glomerular filtration rate (eGFR) ≥ 90 mL/min/1.73 m². However, no significant improvement in prognosis was observed with tirofiban in patients with eGFR < 90 mL/min/1.73 m². Interaction analysis suggested a potential influence of renal function on tirofiban efficacy.

Conclusion: Renal function may impact the efficacy of tirofiban. Administration of tirofiban in direct thrombectomy patients with normal renal function is safe and improves prognosis. However, the prognostic benefits of tirofiban are limited in patients with impaired renal function.

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肾功能会影响急性缺血性脑卒中血栓切除术患者服用替罗非班的安全性和有效性。

背景：急性缺血性脑卒中对健康构成重大威胁，血栓切除术已成为常规治疗方法。替罗非班已成为一种很有前景的辅助疗法，可最大限度地减少血栓切除术后的再闭塞。我们旨在研究肾功能是否会影响接受血管内治疗的患者使用替罗非班的安全性和有效性：方法：对卒中单元收集的患者临床数据进行分析。方法：对卒中单元收集的患者临床数据进行分析，并将改良Rankin量表评分和症状性颅内出血（sICH）作为结果测量指标：结果：共纳入 409 名患者（平均年龄：66.5 岁，292 名男性 [71.4%]）。在估计肾小球滤过率（eGFR）≥90 mL/min/1.73 m²的患者中，替罗非班能明显改善患者3个月的功能预后（调整后比值比[aOR] = 2.408，95%置信区间[CI] 1.120-5.175），降低3个月死亡率（aOR = 0.364，95% CI 0.155-0.856），减少sICH发生率（aOR = 0.339，95% CI 0.149-0.767）。然而，在估计肾小球滤过率（eGFR）≥90 mL/min/1 73 m²的患者中，没有观察到替罗非班能明显改善预后：肾功能可能会影响替罗非班的疗效。对肾功能正常的直接血栓切除术患者使用替罗非班是安全的，并能改善预后。然而，对于肾功能受损的患者，替罗非班对预后的益处有限。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Interventional Neuroradiology CLINICAL NEUROLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

3.60

自引率

11.80%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...