Safety and efficacy of tirofiban combined with intravenous thrombolysis and endovascular treatment in acute large vessel occlusion stroke
This study assesses the safety and efficacy of tirofiban for patients with large vessel occlusion stroke after intravenous thrombolysis. This study data was from SUSTAIN, DEVT, and RESCUE BT trials. According to whether the use of tirofiban who underwent endovascular treatment and preceding intraven...
Gespeichert in:
| Veröffentlicht in: | Clinical neurology and neurosurgery 2024-09, Vol.244, p.108463, Article 108463 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | |
| container_start_page | 108463 |
| container_title | Clinical neurology and neurosurgery |
| container_volume | 244 |
| creator | Su, Shixing Bai, Xiubin Li, Qin Yue, Chengsong Yang, Jie Huang, Jiacheng Kong, Weilin Guo, Changwei Hu, Jinrong Liu, Shuai Yang, Dahong Song, Jiaxing Peng, Zhouzhou Li, Linyu Tian, Yan Li, Fengli Zi, Wenjie Liu, Xiang |
| description | This study assesses the safety and efficacy of tirofiban for patients with large vessel occlusion stroke after intravenous thrombolysis.
This study data was from SUSTAIN, DEVT, and RESCUE BT trials. According to whether the use of tirofiban who underwent endovascular treatment and preceding intravenous thrombolysis was divided into the tirofiban group and the no-tirofiban group. The safety outcomes were symptomatic intracranial hemorrhage, any intracranial hemorrhage within 48 h, and 3-month mortality. The efficacy outcome was defined as a score of 0–2 on the modified Rankin Scale scores at 3 months.
A total of 372 patients with intravenous thrombolysis were included in these SUSTAIN, DEVT, and RESCUE BT trials. Adjusted multivariate analysis showed that tirofiban with intravenous thrombolysis was not associated with symptomatic intracranial hemorrhage (aOR, 0.87; 95 % CI, 0.49–1.57; P=0.65), any intracranial hemorrhage within 48 h (aOR, 1.00; 95 % CI, 0.60–1.66; P=1.00), 3-month mortality (aOR, 1.10; 95 % CI, 0.56–2.19; P=0.78) and 3-month modified Rankin Scale scores 0–2 (aOR, 0.72; 95 % CI, 0.42–1.25; P=0.25) in patients with acute large vessel occlusion. In the subgroup analysis, we found that tirofiban was not recommended for females (aOR, 0.34; 95 % CI, 0.12–0.93), baseline Alberta Stroke Program Early CT Score≤9 (aOR, 0.37; 95 % CI, 0.18–0.76), and cardiogenic embolism (aOR, 0.36; 95 % CI, 0.14–0.97).
Tirofiban combined with intravenous thrombolysis in patients with acute large vessel occlusion may be safe. Further studies need to confirm the effectiveness of tirofiban after intravenous thrombolysis in different stroke etiology.
●Tirofiban with IVT was not associated with sICH and any ICH within 48 h in patients with acute large vessel occlusion.●Tirofiban combined with IVT in patients with acute large vessel occlusion was safe.●Tirofiban combined with IVT did not result in a superior outcome in terms of a 3-month mRS score of 0-2.●Tirofiban combined with IVT was not recommended for baseline ASPECTS ≤9 and cardiogenic embolism. |
| doi_str_mv | 10.1016/j.clineuro.2024.108463 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3084770911</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0303846724003500</els_id><sourcerecordid>3089289192</sourcerecordid><originalsourceid>FETCH-LOGICAL-c273t-89ca2172b4970569e9f0078658ea887b1bedcd17ee51432e60fbfba0baf3c2413</originalsourceid><addsrcrecordid>eNqFkc2OFCEUhYlx4rQzvsKExI2bavmpLmCnmfiXTOLCmTUB6uLQVsEIVJt-BN9aOjXjwo0rksN3zoV7ELqiZEsJHd7ut24KEZactoywvomyH_gztKFSsG5Qg3yONoQT3jVdnKOXpewJIZwP8gU654rsOGd0g35_Mx7qEZs4YvA-OOOOOHlcQ04-WBOxS7Ntk0b8K9R7HGLN5gAxLQXX-9zu0nQsoawBcUwHU9wymYxrBlNniLV5sHFLBdzk74APUApMODk3LSWkiEvN6QdcojNvpgKvHs8LdPfxw-315-7m66cv1-9vOscEr51UzjAqmO2VILtBgfKECDnsJBgphaUWRjdSAbCjPWcwEG-9NcQazx3rKb9Ab9bch5x-LlCqnkNxME0mQvuV5m2TQhBFT-jrf9B9WnJsrztRiklFFWvUsFIup1IyeP2Qw2zyUVOiT2XpvX4qS5_K0mtZzXj1GL_YGca_tqd2GvBuBaDt4xAg6-ICRAdjyOCqHlP434w_zy-sOw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3089289192</pqid></control><display><type>article</type><title>Safety and efficacy of tirofiban combined with intravenous thrombolysis and endovascular treatment in acute large vessel occlusion stroke</title><source>Elsevier ScienceDirect Journals Complete</source><creator>Su, Shixing ; Bai, Xiubin ; Li, Qin ; Yue, Chengsong ; Yang, Jie ; Huang, Jiacheng ; Kong, Weilin ; Guo, Changwei ; Hu, Jinrong ; Liu, Shuai ; Yang, Dahong ; Song, Jiaxing ; Peng, Zhouzhou ; Li, Linyu ; Tian, Yan ; Li, Fengli ; Zi, Wenjie ; Liu, Xiang</creator><creatorcontrib>Su, Shixing ; Bai, Xiubin ; Li, Qin ; Yue, Chengsong ; Yang, Jie ; Huang, Jiacheng ; Kong, Weilin ; Guo, Changwei ; Hu, Jinrong ; Liu, Shuai ; Yang, Dahong ; Song, Jiaxing ; Peng, Zhouzhou ; Li, Linyu ; Tian, Yan ; Li, Fengli ; Zi, Wenjie ; Liu, Xiang</creatorcontrib><description>This study assesses the safety and efficacy of tirofiban for patients with large vessel occlusion stroke after intravenous thrombolysis.
This study data was from SUSTAIN, DEVT, and RESCUE BT trials. According to whether the use of tirofiban who underwent endovascular treatment and preceding intravenous thrombolysis was divided into the tirofiban group and the no-tirofiban group. The safety outcomes were symptomatic intracranial hemorrhage, any intracranial hemorrhage within 48 h, and 3-month mortality. The efficacy outcome was defined as a score of 0–2 on the modified Rankin Scale scores at 3 months.
A total of 372 patients with intravenous thrombolysis were included in these SUSTAIN, DEVT, and RESCUE BT trials. Adjusted multivariate analysis showed that tirofiban with intravenous thrombolysis was not associated with symptomatic intracranial hemorrhage (aOR, 0.87; 95 % CI, 0.49–1.57; P=0.65), any intracranial hemorrhage within 48 h (aOR, 1.00; 95 % CI, 0.60–1.66; P=1.00), 3-month mortality (aOR, 1.10; 95 % CI, 0.56–2.19; P=0.78) and 3-month modified Rankin Scale scores 0–2 (aOR, 0.72; 95 % CI, 0.42–1.25; P=0.25) in patients with acute large vessel occlusion. In the subgroup analysis, we found that tirofiban was not recommended for females (aOR, 0.34; 95 % CI, 0.12–0.93), baseline Alberta Stroke Program Early CT Score≤9 (aOR, 0.37; 95 % CI, 0.18–0.76), and cardiogenic embolism (aOR, 0.36; 95 % CI, 0.14–0.97).
Tirofiban combined with intravenous thrombolysis in patients with acute large vessel occlusion may be safe. Further studies need to confirm the effectiveness of tirofiban after intravenous thrombolysis in different stroke etiology.
●Tirofiban with IVT was not associated with sICH and any ICH within 48 h in patients with acute large vessel occlusion.●Tirofiban combined with IVT in patients with acute large vessel occlusion was safe.●Tirofiban combined with IVT did not result in a superior outcome in terms of a 3-month mRS score of 0-2.●Tirofiban combined with IVT was not recommended for baseline ASPECTS ≤9 and cardiogenic embolism.</description><identifier>ISSN: 0303-8467</identifier><identifier>ISSN: 1872-6968</identifier><identifier>EISSN: 1872-6968</identifier><identifier>DOI: 10.1016/j.clineuro.2024.108463</identifier><identifier>PMID: 39053321</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Anterior circulation ; Atherosclerosis ; Cardiac arrhythmia ; Cardiovascular system ; Clinical trials ; Embolism ; Embolisms ; Endovascular treatment ; Etiology ; Hemorrhage ; Intravenous administration ; Intravenous thrombolysis ; Ischemia ; Large vessel occlusion stroke ; Mortality ; Multivariate analysis ; Occlusion ; Stroke ; Thrombolysis ; Thrombolytic drugs ; Tirofiban ; Veins & arteries</subject><ispartof>Clinical neurology and neurosurgery, 2024-09, Vol.244, p.108463, Article 108463</ispartof><rights>2024 Elsevier B.V.</rights><rights>Copyright © 2024 Elsevier B.V. All rights reserved.</rights><rights>2024. Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c273t-89ca2172b4970569e9f0078658ea887b1bedcd17ee51432e60fbfba0baf3c2413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0303846724003500$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39053321$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Su, Shixing</creatorcontrib><creatorcontrib>Bai, Xiubin</creatorcontrib><creatorcontrib>Li, Qin</creatorcontrib><creatorcontrib>Yue, Chengsong</creatorcontrib><creatorcontrib>Yang, Jie</creatorcontrib><creatorcontrib>Huang, Jiacheng</creatorcontrib><creatorcontrib>Kong, Weilin</creatorcontrib><creatorcontrib>Guo, Changwei</creatorcontrib><creatorcontrib>Hu, Jinrong</creatorcontrib><creatorcontrib>Liu, Shuai</creatorcontrib><creatorcontrib>Yang, Dahong</creatorcontrib><creatorcontrib>Song, Jiaxing</creatorcontrib><creatorcontrib>Peng, Zhouzhou</creatorcontrib><creatorcontrib>Li, Linyu</creatorcontrib><creatorcontrib>Tian, Yan</creatorcontrib><creatorcontrib>Li, Fengli</creatorcontrib><creatorcontrib>Zi, Wenjie</creatorcontrib><creatorcontrib>Liu, Xiang</creatorcontrib><title>Safety and efficacy of tirofiban combined with intravenous thrombolysis and endovascular treatment in acute large vessel occlusion stroke</title><title>Clinical neurology and neurosurgery</title><addtitle>Clin Neurol Neurosurg</addtitle><description>This study assesses the safety and efficacy of tirofiban for patients with large vessel occlusion stroke after intravenous thrombolysis.
This study data was from SUSTAIN, DEVT, and RESCUE BT trials. According to whether the use of tirofiban who underwent endovascular treatment and preceding intravenous thrombolysis was divided into the tirofiban group and the no-tirofiban group. The safety outcomes were symptomatic intracranial hemorrhage, any intracranial hemorrhage within 48 h, and 3-month mortality. The efficacy outcome was defined as a score of 0–2 on the modified Rankin Scale scores at 3 months.
A total of 372 patients with intravenous thrombolysis were included in these SUSTAIN, DEVT, and RESCUE BT trials. Adjusted multivariate analysis showed that tirofiban with intravenous thrombolysis was not associated with symptomatic intracranial hemorrhage (aOR, 0.87; 95 % CI, 0.49–1.57; P=0.65), any intracranial hemorrhage within 48 h (aOR, 1.00; 95 % CI, 0.60–1.66; P=1.00), 3-month mortality (aOR, 1.10; 95 % CI, 0.56–2.19; P=0.78) and 3-month modified Rankin Scale scores 0–2 (aOR, 0.72; 95 % CI, 0.42–1.25; P=0.25) in patients with acute large vessel occlusion. In the subgroup analysis, we found that tirofiban was not recommended for females (aOR, 0.34; 95 % CI, 0.12–0.93), baseline Alberta Stroke Program Early CT Score≤9 (aOR, 0.37; 95 % CI, 0.18–0.76), and cardiogenic embolism (aOR, 0.36; 95 % CI, 0.14–0.97).
Tirofiban combined with intravenous thrombolysis in patients with acute large vessel occlusion may be safe. Further studies need to confirm the effectiveness of tirofiban after intravenous thrombolysis in different stroke etiology.
●Tirofiban with IVT was not associated with sICH and any ICH within 48 h in patients with acute large vessel occlusion.●Tirofiban combined with IVT in patients with acute large vessel occlusion was safe.●Tirofiban combined with IVT did not result in a superior outcome in terms of a 3-month mRS score of 0-2.●Tirofiban combined with IVT was not recommended for baseline ASPECTS ≤9 and cardiogenic embolism.</description><subject>Anterior circulation</subject><subject>Atherosclerosis</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular system</subject><subject>Clinical trials</subject><subject>Embolism</subject><subject>Embolisms</subject><subject>Endovascular treatment</subject><subject>Etiology</subject><subject>Hemorrhage</subject><subject>Intravenous administration</subject><subject>Intravenous thrombolysis</subject><subject>Ischemia</subject><subject>Large vessel occlusion stroke</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Occlusion</subject><subject>Stroke</subject><subject>Thrombolysis</subject><subject>Thrombolytic drugs</subject><subject>Tirofiban</subject><subject>Veins & arteries</subject><issn>0303-8467</issn><issn>1872-6968</issn><issn>1872-6968</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc2OFCEUhYlx4rQzvsKExI2bavmpLmCnmfiXTOLCmTUB6uLQVsEIVJt-BN9aOjXjwo0rksN3zoV7ELqiZEsJHd7ut24KEZactoywvomyH_gztKFSsG5Qg3yONoQT3jVdnKOXpewJIZwP8gU654rsOGd0g35_Mx7qEZs4YvA-OOOOOHlcQ04-WBOxS7Ntk0b8K9R7HGLN5gAxLQXX-9zu0nQsoawBcUwHU9wymYxrBlNniLV5sHFLBdzk74APUApMODk3LSWkiEvN6QdcojNvpgKvHs8LdPfxw-315-7m66cv1-9vOscEr51UzjAqmO2VILtBgfKECDnsJBgphaUWRjdSAbCjPWcwEG-9NcQazx3rKb9Ab9bch5x-LlCqnkNxME0mQvuV5m2TQhBFT-jrf9B9WnJsrztRiklFFWvUsFIup1IyeP2Qw2zyUVOiT2XpvX4qS5_K0mtZzXj1GL_YGca_tqd2GvBuBaDt4xAg6-ICRAdjyOCqHlP434w_zy-sOw</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Su, Shixing</creator><creator>Bai, Xiubin</creator><creator>Li, Qin</creator><creator>Yue, Chengsong</creator><creator>Yang, Jie</creator><creator>Huang, Jiacheng</creator><creator>Kong, Weilin</creator><creator>Guo, Changwei</creator><creator>Hu, Jinrong</creator><creator>Liu, Shuai</creator><creator>Yang, Dahong</creator><creator>Song, Jiaxing</creator><creator>Peng, Zhouzhou</creator><creator>Li, Linyu</creator><creator>Tian, Yan</creator><creator>Li, Fengli</creator><creator>Zi, Wenjie</creator><creator>Liu, Xiang</creator><general>Elsevier B.V</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20240901</creationdate><title>Safety and efficacy of tirofiban combined with intravenous thrombolysis and endovascular treatment in acute large vessel occlusion stroke</title><author>Su, Shixing ; Bai, Xiubin ; Li, Qin ; Yue, Chengsong ; Yang, Jie ; Huang, Jiacheng ; Kong, Weilin ; Guo, Changwei ; Hu, Jinrong ; Liu, Shuai ; Yang, Dahong ; Song, Jiaxing ; Peng, Zhouzhou ; Li, Linyu ; Tian, Yan ; Li, Fengli ; Zi, Wenjie ; Liu, Xiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c273t-89ca2172b4970569e9f0078658ea887b1bedcd17ee51432e60fbfba0baf3c2413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Anterior circulation</topic><topic>Atherosclerosis</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular system</topic><topic>Clinical trials</topic><topic>Embolism</topic><topic>Embolisms</topic><topic>Endovascular treatment</topic><topic>Etiology</topic><topic>Hemorrhage</topic><topic>Intravenous administration</topic><topic>Intravenous thrombolysis</topic><topic>Ischemia</topic><topic>Large vessel occlusion stroke</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Occlusion</topic><topic>Stroke</topic><topic>Thrombolysis</topic><topic>Thrombolytic drugs</topic><topic>Tirofiban</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Su, Shixing</creatorcontrib><creatorcontrib>Bai, Xiubin</creatorcontrib><creatorcontrib>Li, Qin</creatorcontrib><creatorcontrib>Yue, Chengsong</creatorcontrib><creatorcontrib>Yang, Jie</creatorcontrib><creatorcontrib>Huang, Jiacheng</creatorcontrib><creatorcontrib>Kong, Weilin</creatorcontrib><creatorcontrib>Guo, Changwei</creatorcontrib><creatorcontrib>Hu, Jinrong</creatorcontrib><creatorcontrib>Liu, Shuai</creatorcontrib><creatorcontrib>Yang, Dahong</creatorcontrib><creatorcontrib>Song, Jiaxing</creatorcontrib><creatorcontrib>Peng, Zhouzhou</creatorcontrib><creatorcontrib>Li, Linyu</creatorcontrib><creatorcontrib>Tian, Yan</creatorcontrib><creatorcontrib>Li, Fengli</creatorcontrib><creatorcontrib>Zi, Wenjie</creatorcontrib><creatorcontrib>Liu, Xiang</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical neurology and neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Su, Shixing</au><au>Bai, Xiubin</au><au>Li, Qin</au><au>Yue, Chengsong</au><au>Yang, Jie</au><au>Huang, Jiacheng</au><au>Kong, Weilin</au><au>Guo, Changwei</au><au>Hu, Jinrong</au><au>Liu, Shuai</au><au>Yang, Dahong</au><au>Song, Jiaxing</au><au>Peng, Zhouzhou</au><au>Li, Linyu</au><au>Tian, Yan</au><au>Li, Fengli</au><au>Zi, Wenjie</au><au>Liu, Xiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and efficacy of tirofiban combined with intravenous thrombolysis and endovascular treatment in acute large vessel occlusion stroke</atitle><jtitle>Clinical neurology and neurosurgery</jtitle><addtitle>Clin Neurol Neurosurg</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>244</volume><spage>108463</spage><pages>108463-</pages><artnum>108463</artnum><issn>0303-8467</issn><issn>1872-6968</issn><eissn>1872-6968</eissn><abstract>This study assesses the safety and efficacy of tirofiban for patients with large vessel occlusion stroke after intravenous thrombolysis.
This study data was from SUSTAIN, DEVT, and RESCUE BT trials. According to whether the use of tirofiban who underwent endovascular treatment and preceding intravenous thrombolysis was divided into the tirofiban group and the no-tirofiban group. The safety outcomes were symptomatic intracranial hemorrhage, any intracranial hemorrhage within 48 h, and 3-month mortality. The efficacy outcome was defined as a score of 0–2 on the modified Rankin Scale scores at 3 months.
A total of 372 patients with intravenous thrombolysis were included in these SUSTAIN, DEVT, and RESCUE BT trials. Adjusted multivariate analysis showed that tirofiban with intravenous thrombolysis was not associated with symptomatic intracranial hemorrhage (aOR, 0.87; 95 % CI, 0.49–1.57; P=0.65), any intracranial hemorrhage within 48 h (aOR, 1.00; 95 % CI, 0.60–1.66; P=1.00), 3-month mortality (aOR, 1.10; 95 % CI, 0.56–2.19; P=0.78) and 3-month modified Rankin Scale scores 0–2 (aOR, 0.72; 95 % CI, 0.42–1.25; P=0.25) in patients with acute large vessel occlusion. In the subgroup analysis, we found that tirofiban was not recommended for females (aOR, 0.34; 95 % CI, 0.12–0.93), baseline Alberta Stroke Program Early CT Score≤9 (aOR, 0.37; 95 % CI, 0.18–0.76), and cardiogenic embolism (aOR, 0.36; 95 % CI, 0.14–0.97).
Tirofiban combined with intravenous thrombolysis in patients with acute large vessel occlusion may be safe. Further studies need to confirm the effectiveness of tirofiban after intravenous thrombolysis in different stroke etiology.
●Tirofiban with IVT was not associated with sICH and any ICH within 48 h in patients with acute large vessel occlusion.●Tirofiban combined with IVT in patients with acute large vessel occlusion was safe.●Tirofiban combined with IVT did not result in a superior outcome in terms of a 3-month mRS score of 0-2.●Tirofiban combined with IVT was not recommended for baseline ASPECTS ≤9 and cardiogenic embolism.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>39053321</pmid><doi>10.1016/j.clineuro.2024.108463</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0303-8467 |
| ispartof | Clinical neurology and neurosurgery, 2024-09, Vol.244, p.108463, Article 108463 |
| issn | 0303-8467 1872-6968 1872-6968 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3084770911 |
| source | Elsevier ScienceDirect Journals Complete |
| subjects | Anterior circulation Atherosclerosis Cardiac arrhythmia Cardiovascular system Clinical trials Embolism Embolisms Endovascular treatment Etiology Hemorrhage Intravenous administration Intravenous thrombolysis Ischemia Large vessel occlusion stroke Mortality Multivariate analysis Occlusion Stroke Thrombolysis Thrombolytic drugs Tirofiban Veins & arteries |
| title | Safety and efficacy of tirofiban combined with intravenous thrombolysis and endovascular treatment in acute large vessel occlusion stroke |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T13%3A27%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Safety%20and%20efficacy%20of%20tirofiban%20combined%20with%20intravenous%20thrombolysis%20and%20endovascular%20treatment%20in%20acute%20large%20vessel%20occlusion%20stroke&rft.jtitle=Clinical%20neurology%20and%20neurosurgery&rft.au=Su,%20Shixing&rft.date=2024-09-01&rft.volume=244&rft.spage=108463&rft.pages=108463-&rft.artnum=108463&rft.issn=0303-8467&rft.eissn=1872-6968&rft_id=info:doi/10.1016/j.clineuro.2024.108463&rft_dat=%3Cproquest_cross%3E3089289192%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3089289192&rft_id=info:pmid/39053321&rft_els_id=S0303846724003500&rfr_iscdi=true |