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

IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Journal of Neurorestoratology Pub Date : 2022-12-01 DOI:10.1016/j.jnrt.2022.100026
Yongpeng Yu , Yali Zheng , Xia Dong , Xiaohong Qiao , Yu Tao
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引用次数: 3

Abstract

Objective

To investigate the effectiveness and safety of tirofiban in patients with acute ischemic stroke (AIS) without large-vessel occlusions and not receiving intravenous thrombolysis.

Methods

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.

Results

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).

Conclusion

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.

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替罗非班在无大血管闭塞且未接受静脉溶栓治疗的急性缺血性卒中患者中的疗效和安全性:一项随机对照开放标签试验
目的探讨替罗非班治疗急性缺血性脑卒中(AIS)无大血管闭塞且未接受静脉溶栓治疗的有效性和安全性。方法共纳入267例患者(替罗非班组134例;对照组133例)。入院后,替罗非班组患者给予替罗非班治疗至少72小时,停药前4小时给予阿司匹林100 mg和氢氯吡格雷75 mg。随访3个月,评估入院时、治疗后24 h、7 d的美国国立卫生研究院卒中量表(NIHSS)评分、卒中发生后48 h内脑出血转化、出血情况。结果两组患者无症状性和症状性颅内出血(siich)、颅外出血事件和血小板减少(p >0.05)。替罗非班组NIHSS评分与治疗后7 d比较差异有统计学意义(p = 0.043)。治疗后90 d,替罗非班组(改良Rankin量表[mRS] = 0,1)预后良好的患者比例高于对照组(p = 0.021)。两组患者mRS评分为0-2分的比例差异无统计学意义(p >0.05)。结论替罗非班治疗72 h (72 h - 108 h)是安全的,可改善无大血管闭塞且未静脉溶栓的AIS患者的长期(90 d)预后。
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来源期刊
Journal of Neurorestoratology
Journal of Neurorestoratology CLINICAL NEUROLOGY-
CiteScore
2.10
自引率
18.20%
发文量
22
审稿时长
12 weeks
期刊最新文献
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