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Safety and preliminary efficacy of early tirofiban treatment after alteplase in acute ischemic stroke patients

Publication
Philips CT Clinical Science Philips Healthcare • USA

Li W, Lin L, Zhang M, Wu Y, Liu C, Li X, Huang S, Liang C, Wang Y, Chen J, Feng W.

* This article originally appeared in the October 2016 edition of Stroke.
Background and Purpose
We investigated whether early initiation of tirofiban, a glycoprotein IIb/IIIa antagonist, is safe, can reduce the risk of reocclusion, and improve outcomes in acute ischemic stroke patients after alteplase.

Methods
Forty-one patients received alteplase followed by intravenous tirofiban infusion for at least 24 hours. The incidence of symptomatic intracranial hemorrhage, systematic bleedings, and death was recorded. The National Institutes of Health stroke scale score was evaluated at 24 hours and at day seven (or discharge). Modified Rankin scale was assessed at three months. Outcomes for these patients were compared with a propensity score–matched historical cohort with alteplase only.

Results
The incidence of symptomatic intracranial hemorrhage, death, or systematic bleedings (P=1.00) was not increased in the alteplase/tirofiban group. At 24 hours, fewer patients experienced reocclusion in the alteplase/tirofiban group (2.4% versus 22.0%; P=0.025). At day seven or discharge, the median National Institutes of Health stroke scale score was significantly lower in the alteplase/tirofiban group (1 versus 6; P=0.002). At three months, more patients had favorable outcomes of modified Rankin scale 0 to 1 (70.7% versus 46.2%; P=0.026).

Conclusions
Intravenous tirofiban immediately after alteplase seems to be safe and potentially more effective when compared with alteplase alone for selected stroke patients.
For more information about this publication, check out the PubMed listing for this article.


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Publication
iCT
brain, Head, head CTA, hemorrhage, Neuro, stroke
 

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