Clinical efficacy and safety of tirofiban combined with dual antiplatelet therapy in patients with progressive stroke / 中国医师进修杂志

ABSTRACT

Objective:To investigate the efficacy and safety of tirofiban combined with dual antiplatelet therapy for progressive stroke, and obtain the effective time and speed of intravenous tirofiban.Methods:The patients with progressive stroke from June to December 2018 in the Second Hospital of Liaocheng Affiliated to Shandong First Medical University were divided into 2 groups: 28 patients were treated with dual antiplatelet (dual antiplatelet group) and 22 patients were treated with tirofiban combined with dual antiplatelet (tirofiban group). The demographic characteristics, risk factors of cerebral infarction, new infarct location and possible pathogenesis were recorded. The beginning of tirofiban, National Institutes of Health stroke scale (NIHSS) score at different time points, complications, and intravenous infusion effective time, maintenance dose and speed were recorded. NIHSS score was recorded for 14 d and modified Rankin scale (mRS) score was recorded for 90 d after discharge.Results:After 14 d of continuous treatment in the dual antiplatelet group, the NIHSS score decreased (2.92±1.13) scores. One case had gastrointestinal hemorrhage, and there were no intracranial hemorrhage complications. After 14 days of continuous treatment in the tirofiban group, the NIHSS score decreased (3.46±1.71) scored. One case had skin and mucosa hemorrhage, and there were no intracranial hemorrhage complications. In tirofiban group, the effective time of intravenous infusion was 42.2 to 135.7 (86.6 ± 42.3) h, and the infusion speed was 0.15 to 0.45 (0.31 ± 0.12) mg/h. Compared with the dual antiplatelet group, the NIHSS score and 90-day mRS score of tirofiban group decreased significantly: (3.36 ± 1.71) scores vs. (4.75 ± 2.30) scores and (2.93 ± 1.04) scores vs. (3.52 ± 1.83) scores, and there were statistical differences ( P<0.05). Conclusions:Intravenous tirofiban combined with dual antiplatelet therapy for progressive stroke may be a relatively effective method.