Efficacy And Safety Of Antiplatelet Therapy For Ischemic Stroke Without Large Arterial Occlusion By Intravenous Tirofiban

Introduction: All over the world, Each year twelve million people develop ischemic stroke and 30-40% of them do not have visible arterial occlusions at presentation. Hypothesis: In this study, we aim to investigate whether intravenous antiplatelet agent tirofiban in acute ischemic stroke(AIS) patients without large arterial occlusion(LAO) is effect or safe. Material and methods: We performed an open-label study to collect data of patients without LAO and without thrombolytic therapy within 24 hours from the symptom onset.These patients were divided into 2 groups: those who received tirofiban(tirofiban group) and those who did not received tirofiban(control group).The safety endpoint was the incidence of symptomatic intracranial hemorrhage(SICH) within 72 hours. The efficacy outcome measure was the National Institutes of Health Stroke Scale (NIHSS) score improvement at 24 hours and 7 days and modified Rankin Scale (mRS) score ≤1 or return to baseline mRS at 90 days. Results: Of 105 subjects, 53 received Intravenous tirofiban and 52 did not receive it. No patients in our trial had SICH. At 90 days, 67.9%(36/53)of the tirofiban group had mRS ≤1 or return to baseline mRS versus 53.8%(28/52)in control group(P=0.032). At 24 hour in the hospital, the NIHSS score improvement was significantly higer in the tirofiban group compared with control group(p=0.004). At hospital day 7 or hospital discharge, the NIHSS score improved significantly in the tirofiban group compared with the control group (p=0.009). Conclusions: This study provided data that patients with ischemic stroke who did not have LAO and not receive thrombolysis therapy may benefit from Intravenous Tirofiban.