Treating stroke patients, especially those who don’t have blockages in large or medium-sized blood vessels, can be difficult.
Standard treatments like thrombolysis (which dissolves clots) or thrombectomy (which removes clots) aren’t always suitable for these patients. This leaves doctors looking for other options to help improve patient recovery.
A team of researchers, led by Wenjie Zi, M.D., from Xinqiao Hospital and the Second Affiliated Hospital in Chongqing, China, conducted a study to explore alternative treatments for stroke patients who don’t have large vessel blockages but still suffer from significant stroke symptoms.
Their research focused on using tirofiban, a drug that helps prevent blood clots, as a possible treatment.
The study involved 1,177 patients from multiple centers. These patients either:
- Were ineligible for standard clot-busting treatments like thrombolysis or thrombectomy,
- Had recently suffered a stroke,
- Experienced a worsening of stroke symptoms shortly after the onset,
- Showed early signs of neurological decline after receiving thrombolysis, or
- Did not see improvement after receiving thrombolysis within 4 to 24 hours.
To participate in the study, patients had to have significant symptoms, including a National Institutes of Health Stroke Scale (NIHSS) score of 5 or greater, meaning moderate to severe symptoms, and at least one limb with significant weakness.
Participants were divided into two groups. One group of 606 patients received intravenous tirofiban for two days, while the other group of 571 patients was given oral aspirin for the same period. Afterward, both groups continued to take aspirin daily for 90 days.
The results showed that 29.1% of the patients who received tirofiban achieved an excellent recovery, defined as having a score of 0 or 1 on the modified Rankin Scale (mRS), a scale that measures the degree of disability or dependence in daily activities.
In comparison, 22.2% of patients who took aspirin reached the same level of recovery. This translates to an adjusted risk ratio of 1.26, indicating that those receiving tirofiban had a 26% higher chance of an excellent recovery compared to those on aspirin.
However, the study’s secondary outcomes, which looked at other aspects of recovery, didn’t show as clear a benefit for tirofiban.
Mortality rates were nearly the same between the two groups. Additionally, 1% of patients in the tirofiban group experienced symptomatic intracranial bleeding, while none in the aspirin group had this complication.
Despite the small risk of bleeding, the study’s authors concluded that tirofiban was linked to a higher likelihood of a good recovery at 90 days than aspirin.
This suggests that tirofiban could be a valuable option for stroke patients who aren’t candidates for traditional clot-removal procedures, offering them a better chance of recovery.
Tirofiban works by preventing platelets, a type of blood cell, from sticking together to form clots. Since clots are a major cause of strokes, keeping platelets from clumping can help reduce the risk of further damage.
The findings from this study offer new insights into how this drug could be used to help certain stroke patients recover better, particularly those with ongoing symptoms but no large vessel blockages.
For patients who don’t respond to conventional treatments or who have a rapid progression of symptoms, tirofiban may provide a better outcome than the widely used aspirin.
While further research is needed to confirm these findings and explore potential risks like bleeding, this study represents an important step toward improving stroke treatment for a specific group of patients.
If you care about stroke, please read studies about how to eat to prevent stroke, and diets high in flavonoids could help reduce stroke risk.
For more information about health, please see recent studies about how Mediterranean diet could protect your brain health, and wild blueberries can benefit your heart and brain.
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