Bu Zhiping, Sun Dapeng, Zhang Xiaoli, Ma Ning, Gao Feng, Mo Dapeng, Meng Qingwei, Miao Zhongrong
Department of Neurology, Liangxiang Hospital of Beijing Fangshan District, Beijing, China.
Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
J Stroke Cerebrovasc Dis. 2025 Oct;34(10):108420. doi: 10.1016/j.jstrokecerebrovasdis.2025.108420. Epub 2025 Aug 11.
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.
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.
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).
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.
gov. Unique identifier: NCT03370939.
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告结果并不一致。在本研究中，我们专门针对颅内动脉粥样硬化疾病患者，评估血管内治疗期间静脉注射替罗非班的有效性和安全性。
参与者来自ANGEL-ACT注册研究（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急诊工作流程改进），并分为两组。治疗组（静脉注射替罗非班组，n = 254）接受替罗非班持续静脉给药，而对照组（未静脉注射替罗非班组，n = 248）未接受静脉注射替罗非班。随后对两组进行1:1倾向评分匹配（PSM）。我们比较了匹配前和匹配后两组人群的结局。
对照组90天改良Rankin量表（mRS）评分的中位数（四分位间距[IQR]）为3（0 - 5），静脉注射替罗非班组为1（0 - 4）。90天mRS序贯分布的调整后共同比值比（OR）为1.61（95%CI，1.12 - 2.31；P = 0.010）。良好结局率在对照组为42.3%，静脉注射替罗非班组为50.4%，调整后OR为1.59（95%CI，1.04 - 2.42；P = 0.032）。功能独立率在对照组为44.0%，静脉注射替罗非班组为53.5%，调整后OR为1.72（95%CI，1.13 - 2.63；P = 0.012）。完全再通率在对照组为52.4%，静脉注射替罗非班组为65.4%，调整后OR为1.58（95%CI，1.04 - 2.40；P = 0.033）。在匹配后结局分析中，两组之间仅完全再通率的结局存在差异，OR为1.79（95%CI，1.09 - 2.97；P = 0.023）。
使用静脉注射替罗非班作为辅助治疗可能改善颅内动脉粥样硬化大血管闭塞血管内治疗患者的预后。
临床试验注册 - 网址：http://www.
gov。唯一标识符：NCT03370939。
