The value of tirofiban in non⁃macrovascular occlusive ischemic stroke beyond time window

Abstract

Objective To observe the clinical value of early application of tirofiban in patients with non⁃macrovascular occlusive ischemic stroke beyondtime window. Methods Clinicaldata of90 patients with non⁃macrovascular occlusive ischemic stroke treated beyond time window from April 2017 to April 2019 were retrospectively analyzed. According to different treatment, they were dividedinto 2 groups,one group given tirofiban combined with double antibody treatment (treatment group, 50 cases) and another group given double antibody treatment only (control group, 40 cases). National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the neurological status of patients on the 1st, 3rd and 7th day of treatment. On the day of admission and 3 months after treatment, modified Rankin Scale (mRS) and Activities of Daily Living Scale (ADL) were used to evaluate the neurological recovery and activities of daily living. The occurrence of bleeding and severe thrombocytopenia (platelet count <100×109/L) during the treatment was also recorded in 2 groups. Results Differences in NIHSS scores between 2 groups at different time points after treatment were statistically significant (P=0.000). On the 7th day of treatment in the control group, the NIHSS scores were lower than those on the 1st day (P=0.000) and on the 3rd day (P=0.000), which suggested that the degree of neurological deficits had improved. The NIHSS scores on the 1st, 3rd and 7th day after treatment showed a gradual downward trend (P=0.000, for all), and was significantly lower than the control group (P=0.000). After 3 months oftreatmentin 2 groups,the mRS score was lower than that before treatment (P=0.000), while the ADL score was higher than that before treatment (P=0.000). The mRS score in the treatment group was lower than control group (P=0.000), and the ADL score was higher than control group (P =0.003). There was no significant difference in the incidence of bleeding and severe thrombocytopenia between the treatment group and the control group [26% (13/50) vs. 35% (14/40); χ2=0.483, P=0.439]. Conclusions The early application of tirofiban in patients with non⁃macrovascular occlusive ischemic stroke beyond time window can significantly improve the patient's neurological function, improve the quality of life and activities of daily living. DOI：10.3969/j.issn.1672⁃6731.2020.08.015

Keywords

• stroke
• brain ischemia
• platelet aggregation inhibitors