Evaluation of safety and efficacy of Tirofiban injection for treating acute ischemic stroke beyond standard time window

Abstract To evaluate the safety and efficacy of tirofiban in the treatment of acute ischemic stroke (AIS). Clinical data of 152 AIS patients with small vessel occlusion admitted in 2023 were retrospectively analyzed. These patients did not receive intravenous thrombolysis and endovascular treatment...

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Main Authors: Qian Yang, Qiaofeng He, Xinfa Mao, Weibing Fan, Xin Luo
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-11882-2
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author Qian Yang
Qiaofeng He
Xinfa Mao
Weibing Fan
Xin Luo
author_facet Qian Yang
Qiaofeng He
Xinfa Mao
Weibing Fan
Xin Luo
author_sort Qian Yang
collection DOAJ
description Abstract To evaluate the safety and efficacy of tirofiban in the treatment of acute ischemic stroke (AIS). Clinical data of 152 AIS patients with small vessel occlusion admitted in 2023 were retrospectively analyzed. These patients did not receive intravenous thrombolysis and endovascular treatment within 72 h of onset. Patients were divided into two groups (n = 76 each group): a dual antiplatelet group (aspirin + clopidogrel for 14 days, followed by aspirin alone) and a tirofiban group (dual antiplatelet therapy plus tirofiban). Neurological deficits and functional outcomes were assessed before treatment, on day 7, and day 90. Serum hs-CRP and IL-6 levels were measured prior to treatment and on day 7. Symptom aggravation, symptomatic bleeding, and mortality within 90 days were also recorded. Baseline characteristics of the two groups were comparable. Tirofiban treatment significantly improved mRS scores from baseline to day 7 (t = 5.94, p < 0.001) and day 90 (t = 5.67, p < 0.001) (F = 53.13, p < 0.001), with improvements persisting after adjusting for baseline scores (F = 32.56, p < 0.001). Moreover, tirofiban treatment significantly reduced NIHSS scores at days 7 (mean difference = − 0.97 (95% CI: − 1.53, − 0.41); t = 3.57, p < 0.001) and 90 (mean difference = − 0.82 (95% CI: − 1.29, − 0.34); t = 3.97, p < 0.001) and increased Barthel Index scores at days 7 (mean difference = 9.8 (95% CI: 4.3, 15.3); t = − 3.14, p = 0.002) and 90 (mean difference = 11.7 (95% CI: 6.2, 17.2); t = − 4.41, p < 0.001), indicating greater functional independence. No significant differences were observed between the two groups in inflammatory markers (hs-CRP and IL-6), intracranial hemorrhage, or mortality. However, there was a trend toward a higher rate of deterioration in the dual antiplatelet group (13.4% vs. 5.6%). Tirofiban combined with conventional treatment significantly improves neurological deficits and disease outcomes in AIS patients without increasing the risk of bleeding and mortality.
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spelling doaj-art-c04fe136f0a0470a90e5f15818cfdd442025-08-20T04:02:46ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-11882-2Evaluation of safety and efficacy of Tirofiban injection for treating acute ischemic stroke beyond standard time windowQian Yang0Qiaofeng He1Xinfa Mao2Weibing Fan3Xin Luo4Department of Neurology, The Third Hospital of ChangshaDepartment of Neurology, The Third Hospital of ChangshaDepartment of Neurology, The Third Hospital of ChangshaDepartment of Neurology, The Third Hospital of ChangshaDepartment of Neurology, The Third Hospital of ChangshaAbstract To evaluate the safety and efficacy of tirofiban in the treatment of acute ischemic stroke (AIS). Clinical data of 152 AIS patients with small vessel occlusion admitted in 2023 were retrospectively analyzed. These patients did not receive intravenous thrombolysis and endovascular treatment within 72 h of onset. Patients were divided into two groups (n = 76 each group): a dual antiplatelet group (aspirin + clopidogrel for 14 days, followed by aspirin alone) and a tirofiban group (dual antiplatelet therapy plus tirofiban). Neurological deficits and functional outcomes were assessed before treatment, on day 7, and day 90. Serum hs-CRP and IL-6 levels were measured prior to treatment and on day 7. Symptom aggravation, symptomatic bleeding, and mortality within 90 days were also recorded. Baseline characteristics of the two groups were comparable. Tirofiban treatment significantly improved mRS scores from baseline to day 7 (t = 5.94, p < 0.001) and day 90 (t = 5.67, p < 0.001) (F = 53.13, p < 0.001), with improvements persisting after adjusting for baseline scores (F = 32.56, p < 0.001). Moreover, tirofiban treatment significantly reduced NIHSS scores at days 7 (mean difference = − 0.97 (95% CI: − 1.53, − 0.41); t = 3.57, p < 0.001) and 90 (mean difference = − 0.82 (95% CI: − 1.29, − 0.34); t = 3.97, p < 0.001) and increased Barthel Index scores at days 7 (mean difference = 9.8 (95% CI: 4.3, 15.3); t = − 3.14, p = 0.002) and 90 (mean difference = 11.7 (95% CI: 6.2, 17.2); t = − 4.41, p < 0.001), indicating greater functional independence. No significant differences were observed between the two groups in inflammatory markers (hs-CRP and IL-6), intracranial hemorrhage, or mortality. However, there was a trend toward a higher rate of deterioration in the dual antiplatelet group (13.4% vs. 5.6%). Tirofiban combined with conventional treatment significantly improves neurological deficits and disease outcomes in AIS patients without increasing the risk of bleeding and mortality.https://doi.org/10.1038/s41598-025-11882-2Acute ischemic strokeTirofibanStandard time windowMortalityCerebral hemorrhage
spellingShingle Qian Yang
Qiaofeng He
Xinfa Mao
Weibing Fan
Xin Luo
Evaluation of safety and efficacy of Tirofiban injection for treating acute ischemic stroke beyond standard time window
Scientific Reports
Acute ischemic stroke
Tirofiban
Standard time window
Mortality
Cerebral hemorrhage
title Evaluation of safety and efficacy of Tirofiban injection for treating acute ischemic stroke beyond standard time window
title_full Evaluation of safety and efficacy of Tirofiban injection for treating acute ischemic stroke beyond standard time window
title_fullStr Evaluation of safety and efficacy of Tirofiban injection for treating acute ischemic stroke beyond standard time window
title_full_unstemmed Evaluation of safety and efficacy of Tirofiban injection for treating acute ischemic stroke beyond standard time window
title_short Evaluation of safety and efficacy of Tirofiban injection for treating acute ischemic stroke beyond standard time window
title_sort evaluation of safety and efficacy of tirofiban injection for treating acute ischemic stroke beyond standard time window
topic Acute ischemic stroke
Tirofiban
Standard time window
Mortality
Cerebral hemorrhage
url https://doi.org/10.1038/s41598-025-11882-2
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AT xinfamao evaluationofsafetyandefficacyoftirofibaninjectionfortreatingacuteischemicstrokebeyondstandardtimewindow
AT weibingfan evaluationofsafetyandefficacyoftirofibaninjectionfortreatingacuteischemicstrokebeyondstandardtimewindow
AT xinluo evaluationofsafetyandefficacyoftirofibaninjectionfortreatingacuteischemicstrokebeyondstandardtimewindow