AUTHOR=Huo Xiaochuan , Raynald  , Wang Anxin , Mo Dapeng , Gao Feng , Ma Ning , Wang Yilong , Wang Yongjun , Miao Zhongrong 

TITLE=Safety and Efficacy of Tirofiban for Acute Ischemic Stroke Patients With Large Artery Atherosclerosis Stroke Etiology Undergoing Endovascular Therapy

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.630301

DOI=10.3389/fneur.2021.630301

ISSN=1664-2295

ABSTRACT=<p><bold>Objective:</bold> To investigate the safety and efficacy of tirofiban in acute ischemic stroke (AIS) patients with large artery atherosclerosis (LAA) stroke etiology receiving endovascular therapy (EVT).</p><p><bold>Methods:</bold> In this multi-center prospective study, patients who were considered to have an indication received a low dose intra-arterial bolus (0.25–1 mg) of tirofiban. The safety and efficacy outcomes at 90-day follow-ups included symptomatic intracranial hemorrhage (sICH), recanalization rate, functional outcome, and mortality.</p><p><bold>Results:</bold> Among the 649 AIS patients with LAA, those in the tirofiban group (<italic>n</italic> = 244) showed higher systolic blood pressure (BP) and NIHSS score on admission, puncture-to-recanalization time, lower frequency of intravenous thrombolysis and intra-arterial thrombolysis, higher frequency of antiplatelet, heparinization, mechanical stent retrieval, aspiration, balloon angioplasty, and more retrieval times compared with those in the non-tirofiban group (<italic>n</italic> = 405) (all <italic>P</italic> &lt; <italic>0.05</italic>). Tirofiban was found to be associated with superior clinical outcomes in anterior circulation stroke and major stroke patients [adjusted odds ratio (OR) = 2.163, 95% confidence interval (CI) = 1.130–4.140, <italic>P</italic> = <italic>0.02</italic> and adjusted OR = 2.361, 95% CI = 1.326–4.202, <italic>P</italic> = <italic>0.004</italic>, respectively] and a lower risk of mortality at 90-day follow-ups (adjusted OR = 0.159, 95% CI = 0.042–0.599, <italic>P</italic> = <italic>0.007</italic> and adjusted OR = 0.252, 95% CI = 0.103–0.621, <italic>P</italic> = <italic>0.003</italic>, respectively). There was no significant difference in sICH between the two groups.</p><p><bold>Conclusions:</bold> Tirofiban in AIS patients with LAA undergoing EVT is safe and may benefit the functional outcomes in anterior circulation and major stroke patients and showed a trend for reduced mortality.</p>