The role of intravenous tirofiban in patients undergoing endovascular treatment for acute intracranial atherosclerotic occlusion

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-08-11 DOI:10.1016/j.jstrokecerebrovasdis.2025.108420

Zhiping Bu MD , Dapeng Sun MD , Xiaoli Zhang PhD , Ning Ma MD , Feng Gao MD , Dapeng Mo MD , Qingwei Meng MD , Zhongrong Miao MD , ANGEL-ACT study group

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引用次数: 0

Abstract

BACKGROUND AND PURPOSE

Previous reports regarding the impact of tirofiban on patients undergoing endovascular treatment for acute ischemic stroke have shown inconsistencies. In this study, we specifically focused on patients with intracranial atherosclerotic disease to evaluate the effectiveness and safety of intravenous tirofiban during endovascular treatment.

METHODS

The participants were sourced from the ANGEL-ACT Registry (a prospective multicenter registry study focused on key endovascular treatment techniques and emergency workflow improvement for acute ischemic stroke) and categorized into two groups. The treatment group (IV-tirofiban group, n=254) underwent continuous intravenous administration of tirofiban, whereas the control group (No IV-tirofiban group, n=248) did not receive intravenous tirofiban. A 1:1 propensity score matching (PSM) was subsequently conducted between the two groups. We compared the outcomes between the two groups in both the pre-matched and post-matched populations.

RESULTS

The median (interquartile range [IQR]) of 90-day modified Rankin Scale (mRS) score was 3 (0-5) in the control group and 1 (0-4) in the IV-tirofiban group. The adjusted common odds ratio (OR) for the ordinal distribution of the 90-day mRS was 1.61 (95% CI, 1.12-2.31; P=0.010). The rates of excellent outcomes were 42.3% in the control group and 50.4% in the IV-tirofiban group, with an adjusted OR of 1.59 (95% CI, 1.04-2.42; P=0.032). The rates of functional independence were 44.0% in the control group and 53.5% in the IV-tirofiban group, with an adjusted OR of 1.72 (95% CI, 1.13-2.63; P=0.012). The rates of complete recanalization were 52.4% in the control group and 65.4% in the IV-tirofiban group, with an adjusted OR of 1.58 (95% CI, 1.04-2.40; P=0.033). In the analysis of post-matched outcomes, only the outcome of complete recanalization rates differed between the two groups, with an OR of 1.79 (95% CI, 1.09-2.97; P=0.023).

Conclusion

The use of intravenous tirofiban as an adjunctive treatment can potentially improve the prognosis of patients undergoing endovascular treatment for intracranial atherosclerotic large vessel occlusion.

Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT03370939.

查看原文本刊更多论文

静脉注射替罗非班在急性颅内动脉粥样硬化闭塞血管内治疗中的作用。

背景和目的：先前关于替罗非班对急性缺血性卒中血管内治疗患者影响的报道显示出不一致。在这项研究中，我们特别关注颅内动脉粥样硬化性疾病患者，以评估静脉注射替罗非班在血管内治疗中的有效性和安全性。方法：参与者来自ANGEL-ACT注册（一项前瞻性多中心注册研究，重点关注急性缺血性卒中的关键血管内治疗技术和紧急工作流程改进），并分为两组。治疗组（静脉注射替罗非班组，n=254）持续静脉注射替罗非班，对照组（不注射替罗非班组，n=248）不静脉注射替罗非班。随后在两组之间进行了1:1的倾向评分匹配（PSM）。我们比较了两组在配对前和配对后的结果。结果：对照组90天改良Rankin量表（mRS）评分中位数（四分位间距[IQR]）为3 (0-5)，iv -替罗非班组为1（0-4）。90天mRS有序分布的校正共同优势比（OR）为1.61 (95% CI, 1.12-2.31；P = 0.010)。对照组的优良率为42.3%，iv -替罗非班组为50.4%，调整后OR为1.59 (95% CI, 1.04-2.42；P = 0.032)。功能独立性在对照组为44.0%，在iv -替罗非班组为53.5%，调整OR为1.72 (95% CI, 1.13-2.63；P = 0.012)。对照组完全再通率为52.4%，静脉替罗非班组为65.4%，调整后OR为1.58 (95% CI, 1.04-2.40；P = 0.033)。在配对后的结果分析中，两组之间只有完全再通率的结果存在差异，OR为1.79 (95% CI, 1.09-2.97；P = 0.023)。结论：静脉滴注替罗非班作为辅助治疗有可能改善颅内动脉粥样硬化性大血管闭塞行血管内治疗患者的预后。临床试验注册-url: http://www.Clinicaltrials: gov唯一标识符：NCT03370939。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.