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Safety and Efficacy of Tirofiban Combined With Mechanical Thrombectomy Depend on Ischemic Stroke Etiology

Background and Purpose: The clinical use of tirofiban for patients with acute ischemic stroke (AIS) who underwent mechanical thrombectomy (MT) remains controversial. We aimed to evaluate the safety and efficacy of tirofiban combined with MT in AIS patients. Methods: Patients with AIS who underwent M...

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Autores principales: Sun, Chao, Li, Xiang, Zhao, Zheng, Chen, Xiangliang, Huang, Chaoping, Li, Xuemei, Shan, Yajie, Zou, Yang, Liu, Yukai, Ibrahim, Mako, Nyame, Linda, Song, Baili, Wang, Fusang, Zheng, Xiaohan, Hu, Jue, Zhao, Zhihong, Zhou, Junshan, Zou, Jianjun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6828979/
https://www.ncbi.nlm.nih.gov/pubmed/31736848
http://dx.doi.org/10.3389/fneur.2019.01100
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author Sun, Chao
Li, Xiang
Zhao, Zheng
Chen, Xiangliang
Huang, Chaoping
Li, Xuemei
Shan, Yajie
Zou, Yang
Liu, Yukai
Ibrahim, Mako
Nyame, Linda
Song, Baili
Wang, Fusang
Zheng, Xiaohan
Hu, Jue
Zhao, Zhihong
Zhou, Junshan
Zou, Jianjun
author_facet Sun, Chao
Li, Xiang
Zhao, Zheng
Chen, Xiangliang
Huang, Chaoping
Li, Xuemei
Shan, Yajie
Zou, Yang
Liu, Yukai
Ibrahim, Mako
Nyame, Linda
Song, Baili
Wang, Fusang
Zheng, Xiaohan
Hu, Jue
Zhao, Zhihong
Zhou, Junshan
Zou, Jianjun
author_sort Sun, Chao
collection PubMed
description Background and Purpose: The clinical use of tirofiban for patients with acute ischemic stroke (AIS) who underwent mechanical thrombectomy (MT) remains controversial. We aimed to evaluate the safety and efficacy of tirofiban combined with MT in AIS patients. Methods: Patients with AIS who underwent MT from January 2014 to December 2018 were enrolled in three stroke units in China. Subgroup analyses were performed based on stroke etiology which was classified according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria. Safety outcomes were in-hospital intracerebral hemorrhage (ICH), symptomatic intracerebral hemorrhage (sICH) and mortality at 3-month. Efficacy outcomes were favorable functional outcome and functional independence at 3-month and neurological improvement at 24 h, 3 d and discharge. Results: In patients with large artery atherosclerosis (LAA) stroke, multivariate analyses revealed that tirofiban significantly decreased the odds of in-hospital ICH (adjusted OR = 0.382, 95% CI 0.180–0.809) and tended to increase the odds of favorable functional outcome at 3-month (adjusted OR = 3.050, 95% CI 0.969–9.598). By contrast, in patients with cardioembolism (CE) stroke, tirofiban was not associated with higher odds of favorable functional outcome at 3-month (adjusted OR = 0.719, 95% CI 0.107–4.807), but significantly decreased the odds of neurological improvement at 24 h and 3d (adjusted OR = 0.185, 95% CI 0.047–0.726; adjusted OR = 0.268, 95% CI 0.087–0.825). Conclusions: Tirofiban combined with MT appears to be safe and effective in LAA patients, but has no beneficial effect on CE patients.
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spelling pubmed-68289792019-11-15 Safety and Efficacy of Tirofiban Combined With Mechanical Thrombectomy Depend on Ischemic Stroke Etiology Sun, Chao Li, Xiang Zhao, Zheng Chen, Xiangliang Huang, Chaoping Li, Xuemei Shan, Yajie Zou, Yang Liu, Yukai Ibrahim, Mako Nyame, Linda Song, Baili Wang, Fusang Zheng, Xiaohan Hu, Jue Zhao, Zhihong Zhou, Junshan Zou, Jianjun Front Neurol Neurology Background and Purpose: The clinical use of tirofiban for patients with acute ischemic stroke (AIS) who underwent mechanical thrombectomy (MT) remains controversial. We aimed to evaluate the safety and efficacy of tirofiban combined with MT in AIS patients. Methods: Patients with AIS who underwent MT from January 2014 to December 2018 were enrolled in three stroke units in China. Subgroup analyses were performed based on stroke etiology which was classified according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria. Safety outcomes were in-hospital intracerebral hemorrhage (ICH), symptomatic intracerebral hemorrhage (sICH) and mortality at 3-month. Efficacy outcomes were favorable functional outcome and functional independence at 3-month and neurological improvement at 24 h, 3 d and discharge. Results: In patients with large artery atherosclerosis (LAA) stroke, multivariate analyses revealed that tirofiban significantly decreased the odds of in-hospital ICH (adjusted OR = 0.382, 95% CI 0.180–0.809) and tended to increase the odds of favorable functional outcome at 3-month (adjusted OR = 3.050, 95% CI 0.969–9.598). By contrast, in patients with cardioembolism (CE) stroke, tirofiban was not associated with higher odds of favorable functional outcome at 3-month (adjusted OR = 0.719, 95% CI 0.107–4.807), but significantly decreased the odds of neurological improvement at 24 h and 3d (adjusted OR = 0.185, 95% CI 0.047–0.726; adjusted OR = 0.268, 95% CI 0.087–0.825). Conclusions: Tirofiban combined with MT appears to be safe and effective in LAA patients, but has no beneficial effect on CE patients. Frontiers Media S.A. 2019-10-29 /pmc/articles/PMC6828979/ /pubmed/31736848 http://dx.doi.org/10.3389/fneur.2019.01100 Text en Copyright © 2019 Sun, Li, Zhao, Chen, Huang, Li, Shan, Zou, Liu, Ibrahim, Nyame, Song, Wang, Zheng, Hu, Zhao, Zhou and Zou. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Sun, Chao
Li, Xiang
Zhao, Zheng
Chen, Xiangliang
Huang, Chaoping
Li, Xuemei
Shan, Yajie
Zou, Yang
Liu, Yukai
Ibrahim, Mako
Nyame, Linda
Song, Baili
Wang, Fusang
Zheng, Xiaohan
Hu, Jue
Zhao, Zhihong
Zhou, Junshan
Zou, Jianjun
Safety and Efficacy of Tirofiban Combined With Mechanical Thrombectomy Depend on Ischemic Stroke Etiology
title Safety and Efficacy of Tirofiban Combined With Mechanical Thrombectomy Depend on Ischemic Stroke Etiology
title_full Safety and Efficacy of Tirofiban Combined With Mechanical Thrombectomy Depend on Ischemic Stroke Etiology
title_fullStr Safety and Efficacy of Tirofiban Combined With Mechanical Thrombectomy Depend on Ischemic Stroke Etiology
title_full_unstemmed Safety and Efficacy of Tirofiban Combined With Mechanical Thrombectomy Depend on Ischemic Stroke Etiology
title_short Safety and Efficacy of Tirofiban Combined With Mechanical Thrombectomy Depend on Ischemic Stroke Etiology
title_sort safety and efficacy of tirofiban combined with mechanical thrombectomy depend on ischemic stroke etiology
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6828979/
https://www.ncbi.nlm.nih.gov/pubmed/31736848
http://dx.doi.org/10.3389/fneur.2019.01100
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