Intravenous tirofiban following successful reperfusion in intracranial large artery atherosclerotic stroke: A secondary analysis of a randomized clinical trial

作者全名："Huang, Jiacheng; Kong, Weilin; Liu, Chang; Song, Jiaxing; Yang, Jie; Yue, Chengsong; Li, Linyu; Hu, Jinrong; Tian, Yan; Peng, Zhouzhou; Guo, Changwei; Yang, Dahong; Liu, Xiang; Miao, Jian; Zhang, Xiao; Li, Fengli; Saver, Jeffrey L.; Zi, Wenjie"

作者地址："[Huang, Jiacheng; Kong, Weilin; Song, Jiaxing; Yang, Jie; Yue, Chengsong; Li, Linyu; Hu, Jinrong; Tian, Yan; Peng, Zhouzhou; Guo, Changwei; Yang, Dahong; Liu, Xiang; Li, Fengli; Zi, Wenjie] Third Mil Med Univ, Army Med Univ, Xinqiao Hosp, Dept Neurol, 183 Xinqiao Main St, Chongqing 400037, Peoples R China; [Huang, Jiacheng; Kong, Weilin; Song, Jiaxing; Yang, Jie; Yue, Chengsong; Li, Linyu; Hu, Jinrong; Tian, Yan; Peng, Zhouzhou; Guo, Changwei; Yang, Dahong; Liu, Xiang; Li, Fengli; Zi, Wenjie] Third Mil Med Univ, Army Med Univ, Affiliated Hosp 2, 183 Xinqiao Main St, Chongqing 400037, Peoples R China; [Liu, Chang] Chongqing Med Univ, Dept Neurol, Affiliated Hosp 2, 74 Linjiang Rd, Chongqing 400010, Peoples R China; [Miao, Jian] Yanan Univ, Xianyang Hosp, Dept Neurol, 38 Middle Sect Wenlin Rd, Xianyang 712000, Peoples R China; [Zhang, Xiao] Northwest Univ, Xian Hosp No 3, Dept Neurol, Affiliated Hosp, Xian 710000, Peoples R China; [Saver, Jeffrey L.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA; [Saver, Jeffrey L.] Univ Calif Los Angeles, Comprehens Stroke Ctr, David Geffen Sch Med, Los Angeles, CA 90095 USA"

通信作者："Li, FL; Zi, WJ (通讯作者)，Third Mil Med Univ, Army Med Univ, Xinqiao Hosp, Dept Neurol, 183 Xinqiao Main St, Chongqing 400037, Peoples R China.; Li, FL; Zi, WJ (通讯作者)，Third Mil Med Univ, Army Med Univ, Affiliated Hosp 2, 183 Xinqiao Main St, Chongqing 400037, Peoples R China.; Saver, JL (通讯作者)，Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA.; Saver, JL (通讯作者)，Univ Calif Los Angeles, Comprehens Stroke Ctr, David Geffen Sch Med, Los Angeles, CA 90095 USA."

来源：ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:001064612400001

JCR分区：Q1

影响因子：4.4

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

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摘要："Objective: This study aimed to investigate whether treatment with adjunct intravenous tirofiban is associated with improved outcomes following successful reperfusion in patients with intracranial atherosclerotic stroke. Methods: Patients with intracranial large artery atherosclerotic (LAA) stroke and an expanded Treatment in Cerebral Ischemia angiographic score of 2b50 to 3 from the Effect of Intravenous Tirofiban versus Placebo Before Endovascular Throm-bectomy on Functional Outcomes in Large Vessel Occlusion Stroke (RESCUE BT) trial were included. The primary outcome was the difference in proportion of independent functional outcome (modified Rankin score of 0-2 at 90 days). Safety outcomes included the rates of symptomatic intracranial hemorrhage (sICH) and 90-day mortality. Results: Among the 382 patients with intracranial LAA stroke and successful reperfusion, 175 patients (45.8%) were treated with intravenous tirofiban and 207 (54.2%) with placebo. The proportion of patients with independent functional outcome at 90 days was 54.3% (95 out of 175) with tirofiban and 44.0% (91 out of 207) with placebo (adjusted odds ratio [aOR], 1.58; 95% CI, 1.02-2.44; p = 0.04). Intravenous tirofiban was not signif-icantly associated with an increased risk of sICH (12/175 [6.9%] vs. 11/207 [5.3%]; aOR, 1.41; 95% CI, 0.59-3.34; p = 0.44) or 90-day mortality (21/175 [12.0%] vs. 34/207 [16.4%]; aOR, 0.71; 95% CI, 0.38-1.31; p = 0.27). Interpre-tation: Among patients with acute intracranial LAA stroke and successful reper-fusion following endovascular thrombectomy, adjunct intravenous tirofiban was associated with a higher rate of independent functional outcome, without higher rates of sICH or mortality. Confirmatory randomized trials in these patients are desirable."

基金机构：We thank all study participants for their contribution to the study and the research staff at all the participating hospitals.

基金资助正文：We thank all study participants for their contribution to the study and the research staff at all the participating hospitals.