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Subtyping treatment response of tirofiban in acute ischemic stroke based on neuroimaging features
- Source :
- Clinical and Translational Science, Vol 17, Iss 1, Pp n/a-n/a (2024)
- Publication Year :
- 2024
- Publisher :
- Wiley, 2024.
-
Abstract
- Abstract In a previously published clinical trial, we demonstrated that tirofiban was effective and safe in acute ischemic stroke (AIS) patients who did not undergo early recanalization treatments. We aimed to evaluate neuroimaging characteristics and their clinical significance to guide tirofiban treatment. In this post hoc analysis, location of infarcts (anterior circulation stroke [ACS] vs. posterior circulation stroke [PCS]), degree of cerebral artery stenosis (≤69% vs. ≥70% or occlusion), total infarct volume, and ASPECTS were used to predict the treatment effects of tirofiban, defined as the proportions of excellent and favorable functional outcome (modified Rankin Scale [mRS] score of 0–1, 0–2) at 90 days. ACS patients were more likely to achieve excellent (OR 2.08; 95% CI 1.25–3.45; p = 0.004) and favorable functional outcome (OR 2.28; 95% CI 1.24–4.22; p = 0.008) when treated with tirofiban. However, there was no significant difference in PCS patients between tirofiban and the control group. For patients with severe stenosis (≥70% or occlusion), tirofiban treatment improved the proportion of good outcomes (OR 2.84; 95% CI 1.44–5.60; p = 0.002 for mRS 0–1; OR 2.42; 95% CI 1.22–4.77; p = 0.011 for mRS 0–2). Meanwhile, we found that tirofiban improved outcome in patients with ASPECTS 8–10 and was independent of total infarct volume. These findings support the hypothesis that patients with ACS and severe stenosis may be recommended for tirofiban treatment, which can be predicted independent of total infarct volume.
- Subjects :
- Therapeutics. Pharmacology
RM1-950
Public aspects of medicine
RA1-1270
Subjects
Details
- Language :
- English
- ISSN :
- 17528062 and 17528054
- Volume :
- 17
- Issue :
- 1
- Database :
- Directory of Open Access Journals
- Journal :
- Clinical and Translational Science
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.f21930ac01014201a9e0a52054bddb1f
- Document Type :
- article
- Full Text :
- https://doi.org/10.1111/cts.13686