Key result
Intravenous tirofiban combined with DAPT was superior to DAPT alone for achieving a favorable functional outcome at 90 days (63.43% vs 48.08%) in progressive ischemic stroke.
Why the study?
The study was conducted to assess the efficacy and safety of tirofiban in combination with dual-antiplatelet therapy in patients with progressive ischemic stroke.
Does intravenous tirofiban combined with dual-antiplatelet therapy improve clinical outcomes in patients with progressive ischemic stroke?
RCT (n=104)
Does intravenous tirofiban combined with dual-antiplatelet therapy improve clinical outcomes in patients with progressive ischemic stroke?
Intravenous tirofiban combined with DAPT effectively improves clinical outcomes in progressive ischemic stroke patients compared to DAPT alone, despite a small increase in bleeding risk.
May support adjunctive tirofiban in progressive stroke; hypothesis-generating pending randomized confirmation.
This study assessed the efficacy and safety of tirofiban in combination with dual-antiplatelet therapy (DAPT) in progressive ischemic stroke. One hundred and four patients equally divided into a tirofiban group or DAPT group were enrolled from June 2018 to December 2019. Efficacy outcomes included National Institutes of Health Stroke Scale score for 14 days, and modified Rankin scale (mRs) scores as excellent (mRs 0-1) or favorable (mRs 0-2) measured 90 days after stroke. At 14 days, the tirofiban group had a lower National Institutes of Health Stroke Scale score compared with the DAPT group (F = 14.959, P = 0.000). The mRS scores of the 2 groups at 90 days after treatment were significantly different from those before treatment. At 90 days, excellent favorable functional outcome (mRS ≤ 2) was achieved in 33 of 52 (63.43%) patients in the tirofiban group compared with 25 of 52 (48.08%) patients in the DAPT group. The incidence of bleeding was 5.77% in the tirofiban group, compared with 0% in DAPT group. Intravenous (IV) tirofiban alone or combined with DAPT was shown to be safe and effectively improved clinical outcome in progressive ischemic stroke patients. IV tirofiban was shown to be superior to the DAPT regimen.
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Zhang et al. (2021) conducted an RCT in progressive ischemic stroke (n=104). Tirofiban in combination with dual-antiplatelet therapy (DAPT) vs. Dual-antiplatelet therapy (DAPT) was evaluated on Excellent favorable functional outcome (mRS ≤ 2) at 90 days. Intravenous tirofiban combined with DAPT was superior to DAPT alone for achieving a favorable functional outcome at 90 days (63.43% vs 48.08%) in progressive ischemic stroke.
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