Efficacy of Tirofiban Administered at Different Time Points after Intravenous Thrombolytic Therapy with Alteplase in Patients with Acute Ischemic Stroke

摘要

Objective: To evaluate the efficacy of tirofiban administered at different time points within 24 hours of intravenous thrombolysis with alteplase in acute ischemic stroke. Methods: Patients who underwent intravenous thrombolysis with alteplase and fulfilled other inclusion criteria were randomly divided into 4 groups according to the time points of tirofiban administration: Group A (2 h), Group B (2-12 h), Group C (12-24 h), and Group D (control). The changes in National Institutes of Health Stroke Scale score, modified Rankin Scale score, and adverse events were analyzed. Results: At 7 +/- 1 day, the efficacy in Group A was better than that in Group C (P =.006) and Group D (P =.001), but there was no significant difference in the efficacy between Groups A and B (P =.268). Similarly, at 14 +/ 2 d, the efficacy in Group A was better than that in Group C (P =.026) and Group D (P =.001), but there was no significant difference in the efficacy between Groups A and B (P =.394). As evaluated by the modified Rankin Scale, the prognosis in Groups A, B, and C was better than that in Group D (P =.042, .008, .027, respectively), which was unrelated to the time points of tirofiban administration. There was no significant difference in the incidence of adverse events among the four groups. Conclusions: Tirofiban combined with alteplase is effective and safe, and particularly beneficial when administered at 2 hour and 2-12 hours after intravenous thrombolysis with alteplase in acute ischemic stroke.