ABSTRACT
OBJECTIVE: To investigate the safety and efficacy of intravenous Tirofiban infusion after mechanical thrombectomy in patients with acute ischemic stroke. METHODS: A consecutive series of patients with acute ischemic stroke who underwent mechanical thrombectomy were included. The patients were categorized into two groups according to whether they received intravenous Tirofiban infusion after mechanical thrombectomy. Intracranial hemorrhage (ICH) and all-cause mortality were studied as safety outcomes; recanalization of target vessel evaluated by thrombolysis in cerebral infarct (TICI) scale, and neurological improvement evaluated by Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) were studied as efficacy outcomes. RESULTS: A total of 31 patients who underwent mechanical thrombectomy were enrolled, among which 8 (25.81%) received a standard dose of intravenous Tirofiban infusion after mechanical thrombectomy. There was no significant difference in baseline characteristics between the two groups (all P>0.05). None (0.00%) of the patients suffered ICH in the Tirofiban group, while 3 (13.04%) suffered ICH in the control group (P=0.550); similar all-cause mortality rates were found in both groups (25.00% versus 17.39%, P=0.634). In the Tirofiban group, all patients achieved successful recanalization defined by TICI groups (25.00% versus 17.39%, P=0.634). In the und in both groups (25.00% versus 17.39%, P=0.634). In th4). In thle, and neurological improvement evaluated so, 'et al' is notned by 3-month mRS≤2, which were not statistically significant when compared to the control group (all P>0.05). CONCLUSION: Intravenous Tirofiban infusion after mechanical thrombectomy is safe and effective in patients with acute ischemic stroke.
ABSTRACT
We aimed to investigate heart rate recovery (HRR) in patients with transient ischemic attack (TIA) and the relationship between HRR and health-related quality of life (HRQOL).All available patients were enrolled during the enrollment period. A total of 120 patients with TIA and 120 healthy controls were included in this study. A treadmill stress test was performed to calculate the HRR. The HRR were calculated as follows: HRR 1, 2, 3, and 5âminutesâ=âheart rate at peak during exerciseâ-âheart rate at 1, 2, 3, and 5âminutes at rest. All patients enrolled were asked to fill in the Short Form 36 Health Survey to calculate HRQOL.We found that the maximum heart rate of TIA patients was significantly higher than that of healthy controls (166â±â11 vs. 162â±â14âbeats/min, Pâ=â.015). Similarly, maximum systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher in TIA group compared with healthy control group (SBP: 172â±â15 vs. 165â±â14âmm Hg, Pâ<â.001; DBP: 102â±â12 vs. 93â±â16âmm Hg, Pâ<â.001). The HRR were significantly lower in TIA group compared with control group (TIA vs. controls, HRR1: 17â±â7 vs. 30â±â8âbeats/min, HRR2: 32â±â11 vs. 49â±â9âbeats/min, HRR3: 43â±â13 vs. 63â±â12âbeats/min, HRR5: 54â±â16 vs. 73â±â15âbeats/min, all Pâ<â.001). Multivariate analysis showed that older age (Pâ=â.03) and high BMI (Pâ=â.04) were risk factors associated with abnormal HRR in patients with TIA. With regard to HRQOL, we found that role limitations due to physical problems, general health, vitality, and role limitations due to emotional problems were significantly lower in patients with abnormal HRR compared with patients with normal HRR. Multivariate analysis showed that older age (Pâ=â.04) and abnormal HRR (Pâ=â.03) were predictors for poor HRQOL in TIA patients.HRR was impaired in patients with TIA. In addition, TIA patients with abnormal HRR suffered from a significantly poorer HRQOL. Hence, given the prognostic value of HRR, patients with TIA should be monitored to prevent cardiovascular events and to improve HRQOL.
