Key result
Low-dose eptifibatide did not significantly improve overall early neurological recovery compared to oral antiplatelets in patients with progressive ischemic stroke (median ∆NIHSS 2.0 vs 1.5, p=0.053).
Why the study?
Progressive ischemic stroke is a therapeutic challenge in clinical practice, and the safety and effectiveness of eptifibatide for its treatment required investigation.
Does low-dose eptifibatide added to oral antiplatelet therapy improve early neurological recovery in patients with progressive ischemic stroke?
Case-Control (n=74)
No
Does low-dose eptifibatide added to oral antiplatelet therapy improve early neurological recovery in patients with progressive ischemic stroke?
Low-dose eptifibatide is well tolerated and may accelerate early neurological recovery in progressive ischemic stroke caused by small artery occlusion, but not large artery atherosclerosis.
Low-dose eptifibatide may speed early recovery in SAO-type PIS; hypothesis-generating for subtype-specific use, requiring randomized trials.
Progressive ischemic stroke (PIS) is a therapeutic challenge in clinical practice. The present retrospective study aimed to investigate the safety and effectiveness of eptifibatide in the treatment of PIS. The present study enrolled patients with PIS admitted to Xiangtan Central Hospital (Xiangtan, China) between March 2020 and March 2021 with National Institutes of Health Stroke Scale (NIHSS) progression scores of ≥2 points during the initial 72 h. Patients were then divided into two groups according to their different anti-platelet treatment regimens. The control group was administered anti-platelet aggregation with aspirin 100 mg/day, or aspirin 100 mg/day in combination with clopidogrel 75 mg/day, whilst eptifibatide was administered in the eptifibatide group in addition to the treatment regimen used in the control group. Changes in NIHSS scores at the time of progression and 7 days after treatment (∆NIHSS) were used to assess early neurological recovery, and there were no significant differences in ∆NIHSS and adverse reactions between the groups (P>0.05). Subgroup analysis was subsequently performed according to the type of blood vessel that was involved [large artery atherosclerosis (LAA) or small artery occlusion (SAO)]. For the SAO subgroup, the ∆NIHSS in the eptifibatide group was significantly superior to that of the control group (P=0.008), while for the LAA subgroup, there were no significant differences in ∆NIHSS between groups (P=0.334). The present retrospective study found that patients with PIS tolerated eptifibatide treatment well. Eptifibatide exerted different effects on patients with acute PIS involving different types of blood vessels compared with oral antiplatelet drugs. In addition, application of eptifibatide may lead to faster and earlier recovery in patients with SAO, but not in those with LAA. Low-dose eptifibatide is a safe and effective treatment option for patients with PIS caused by SAO.
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Luo et al. (2022) conducted a case-control in Progressive ischemic stroke (n=74). Eptifibatide vs. Oral antiplatelet medication (aspirin 100 mg/day alone or with clopidogrel 75 mg/day) was evaluated on Changes in NIHSS scores at the time of progression and 7 days after treatment (∆NIHSS) (p=0.053). Low-dose eptifibatide did not significantly improve overall early neurological recovery compared to oral antiplatelets in patients with progressive ischemic stroke (median ∆NIHSS 2.0 vs 1.5, p=0.053).
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