Treating stroke can be especially difficult when patients do not have blockages in large or medium-sized brain vessels. In these cases, standard treatments like thrombolysis (clot-busting drugs) or thrombectomy (a procedure to remove a clot) may not be suitable. This leaves doctors with limited options and patients at higher risk of lasting damage.
Now, a new study from researchers in China suggests that a drug called tirofiban might offer better outcomes than aspirin for certain stroke patients.
Tirofiban is a medication that prevents blood platelets from clumping together and forming clots. It’s usually used to treat heart problems, but researchers wanted to see if it could help stroke patients who were not eligible for typical clot-removal treatments.
The study, published in The New England Journal of Medicine, included 1,177 patients who had ischemic strokes but no occlusion (blockage) of large or medium-sized blood vessels. These patients also had fairly serious symptoms, including at least one limb that was moderately or severely weak and a National Institutes of Health Stroke Scale (NIHSS) score of 5 or higher.
Some of the patients were not eligible for thrombolysis or thrombectomy. Others had just had a stroke, experienced worsening symptoms shortly after stroke onset, did not improve after thrombolysis, or saw early neurological decline even after treatment.
The participants were divided into two groups:
- 606 patients received intravenous tirofiban for two days, along with a placebo pill.
- 571 patients received oral aspirin for two days, along with a placebo IV.
- After those two days, everyone in both groups continued with oral aspirin until day 90.
At the end of the 90-day follow-up, the results showed that 29.1% of patients who received tirofiban had an excellent recovery, defined as a score of 0 or 1 on the modified Rankin Scale (a common measure of stroke recovery). In comparison, only 22.2% of those who took aspirin reached the same level of recovery. This means that patients who took tirofiban were more likely to have a nearly full recovery.
However, the results for secondary measures—like smaller improvements or other health indicators—were less clear and did not strongly support the main outcome.
Importantly, death rates were similar in both groups. The risk of symptomatic bleeding in the brain was low, recorded in 1% of the tirofiban group and in none of the aspirin group.
The researchers, led by Dr. Wenjie Zi and colleagues from Xinqiao Hospital and the Second Affiliated Hospital in Chongqing, concluded that tirofiban may offer an advantage for stroke patients who aren’t candidates for standard treatments, especially those with worsening symptoms and no major vessel blockage.
This study sheds light on a potential new strategy to help a specific group of stroke patients who often have limited treatment options. While more research is needed to confirm the long-term safety and effectiveness of tirofiban in broader patient groups, these results are promising.
For people recovering from or at risk of stroke, this research adds to growing knowledge about how to improve outcomes. It also highlights the importance of tailoring treatment to each patient’s condition and response to early therapies.
As always, anyone who has had a stroke or is at risk should speak with their healthcare provider about the best treatment options and preventive steps—including diet, exercise, and medication—based on their individual needs.
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 health information, 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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