Lili Zhao, Yating Jian, Tao Li, Heying Wang, Zhang Lei, Man Sun, Ye Li, Yiheng Zhang, Meijuan Dang, Wang Huqing, Sun Hong, Zhang Ru, Hongxing Zhang, Yi Jia, Luo Guogang, Zhang Guilian
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Here, we performed a comparative retrospective study to investigate whether tirofiban combined with MT improves short- and long-term prognosis in AIS patients and whether its use is associated with complications.</p><p><strong>Method: </strong>Retrospective data were collected for AIS patients admitted between January 2013 and January 2019 at three stroke centers. According to whether tirofiban was used during the operation, patients were divided into tirofiban group and control group. Multivariate and COX regression analyses were performed to determine the association of tirofiban treatment with safety and efficiency in subjects treated with MT.</p><p><strong>Result: </strong>A total of 174 patients were analyzed, of whom 89 (51.1%) were treated with tirofiban. There were no differences in the incidence of symptomatic intracerebral hemorrhage (10.2% <i>vs.</i> 10.6%, <i>p</i>=0.918), parenchymal hemorrhage type 2 (18.0% <i>vs</i>. 16.5%, <i>p</i>=0.793), and reocclusion at 24 h (3.4% <i>vs</i>. 10.6%, <i>p</i>=0.060) between the tirofiban group and control group. Multivariate regression showed that tirofiban was not associated with intracerebral hemorrhage, early neurological deterioration, neurological improvement at 7 days, functional independence at 3-month and 9-month follow-up, or death at 9-month follow-up (adjusted <i>p</i> > 0.05 for all). However, AIS patients treated with MT + tirofiban showed a trend towards acquiring faster functional independence, with a median time to acquire functional independence of 4.0 months compared with 6.5 months in the control group (risk ratio = 1.49, 95% confidence interval 0.98-2.27; long rank <i>p</i>=0.066).</p><p><strong>Conclusion: </strong>Tirofiban may help AIS patients given MT to gain functional independence faster, without increasing the risk of complications.</p>","PeriodicalId":8826,"journal":{"name":"Biochemistry Research International","volume":"2020 ","pages":"5656173"},"PeriodicalIF":3.4000,"publicationDate":"2020-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5656173","citationCount":"12","resultStr":"{\"title\":\"The Safety and Efficiency of Tirofiban in Acute Ischemic Stroke Patients Treated with Mechanical Thrombectomy: A Multicenter Retrospective Cohort Study.\",\"authors\":\"Lili Zhao, Yating Jian, Tao Li, Heying Wang, Zhang Lei, Man Sun, Ye Li, Yiheng Zhang, Meijuan Dang, Wang Huqing, Sun Hong, Zhang Ru, Hongxing Zhang, Yi Jia, Luo Guogang, Zhang Guilian\",\"doi\":\"10.1155/2020/5656173\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Limited comparative studies have reported the safety and efficacy of tirofiban in acute ischemic stroke (AIS) patients after mechanical thrombectomy (MT). 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There were no differences in the incidence of symptomatic intracerebral hemorrhage (10.2% <i>vs.</i> 10.6%, <i>p</i>=0.918), parenchymal hemorrhage type 2 (18.0% <i>vs</i>. 16.5%, <i>p</i>=0.793), and reocclusion at 24 h (3.4% <i>vs</i>. 10.6%, <i>p</i>=0.060) between the tirofiban group and control group. Multivariate regression showed that tirofiban was not associated with intracerebral hemorrhage, early neurological deterioration, neurological improvement at 7 days, functional independence at 3-month and 9-month follow-up, or death at 9-month follow-up (adjusted <i>p</i> > 0.05 for all). 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引用次数: 12
摘要
有限的比较研究报道了替罗非班在急性缺血性卒中(AIS)患者机械取栓(MT)后的安全性和有效性。此外，现有的研究相互不一致，这使得替罗非班在神经干预中的应用不明确。在这里，我们进行了一项比较回顾性研究，以调查替罗非班联合MT是否能改善AIS患者的短期和长期预后，以及其使用是否与并发症有关。方法:收集2013年1月至2019年1月在三个脑卒中中心住院的AIS患者的回顾性数据。根据术中是否使用替罗非班将患者分为替罗非班组和对照组。结果:共分析174例患者，其中89例(51.1%)患者接受替罗非班治疗。在症状性脑出血(10.2% vs. 10.6%， p=0.918)、2型脑实质出血(18.0% vs. 16.5%， p=0.793)和24 h再闭塞(3.4% vs. 10.6%， p=0.060)的发生率方面，替罗非班组与对照组无差异。多因素回归显示替罗非班与脑出血、早期神经功能恶化、7天神经功能改善、3个月和9个月功能独立、9个月死亡均无相关性(校正后p均> 0.05)。然而，接受MT +替罗非班治疗的AIS患者获得功能独立的速度更快，获得功能独立的中位时间为4.0个月，而对照组为6.5个月(风险比= 1.49,95%可信区间0.98-2.27;长秩p=0.066)。结论:替罗非班可以帮助接受MT治疗的AIS患者更快地获得功能独立，且不会增加并发症的风险。
The Safety and Efficiency of Tirofiban in Acute Ischemic Stroke Patients Treated with Mechanical Thrombectomy: A Multicenter Retrospective Cohort Study.
Introduction: Limited comparative studies have reported the safety and efficacy of tirofiban in acute ischemic stroke (AIS) patients after mechanical thrombectomy (MT). Additionally, the available studies are inconsistent with each other, which makes application of tirofiban unclear in neuro-intervention. Here, we performed a comparative retrospective study to investigate whether tirofiban combined with MT improves short- and long-term prognosis in AIS patients and whether its use is associated with complications.
Method: Retrospective data were collected for AIS patients admitted between January 2013 and January 2019 at three stroke centers. According to whether tirofiban was used during the operation, patients were divided into tirofiban group and control group. Multivariate and COX regression analyses were performed to determine the association of tirofiban treatment with safety and efficiency in subjects treated with MT.
Result: A total of 174 patients were analyzed, of whom 89 (51.1%) were treated with tirofiban. There were no differences in the incidence of symptomatic intracerebral hemorrhage (10.2% vs. 10.6%, p=0.918), parenchymal hemorrhage type 2 (18.0% vs. 16.5%, p=0.793), and reocclusion at 24 h (3.4% vs. 10.6%, p=0.060) between the tirofiban group and control group. Multivariate regression showed that tirofiban was not associated with intracerebral hemorrhage, early neurological deterioration, neurological improvement at 7 days, functional independence at 3-month and 9-month follow-up, or death at 9-month follow-up (adjusted p > 0.05 for all). However, AIS patients treated with MT + tirofiban showed a trend towards acquiring faster functional independence, with a median time to acquire functional independence of 4.0 months compared with 6.5 months in the control group (risk ratio = 1.49, 95% confidence interval 0.98-2.27; long rank p=0.066).
Conclusion: Tirofiban may help AIS patients given MT to gain functional independence faster, without increasing the risk of complications.
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