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American Heart Association

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Final ID: DP2

Effect of Tirofiban on 90-day Functional Outcomes in Patients with Presumed Non-Embolic Stroke

Abstract Body: Introduction: Tirofiban has shown a potential effect in reducing early neurological deterioration and improving clinical outcomes in selected patients with non-embolic stroke. We aim to analyze the effect of tirofiban versus standard acute therapy on 90-day outcomes in patients with presumed non-embolic stroke.

Methods: Multicentric retrospective cohort study including consecutive AIS patients presenting within 24h from symptom onset, baseline mRS 0-1, absence of cortical symptoms, identifiable vessel occlusion or other imaging features suggestive of embolic stroke; anticoagulated patients were excluded from the analysis. Patients received either tirofiban (±ASA) or standard acute therapy (IVT or oral antiplatelets). Primary outcome was functional independence at 90 days (mRS 0-2); secondary efficacy and safety outcomes included: excellent outcome (mRS 0-1); sICH, systemic bleeding and neurological deterioration (4 point increase in NIHSS). Exploratory subgroup analysis was performed for severity (NIHSS ≥5 vs <5) and standard therapy (IVT vs oral APT) groups.

Results: Of 290 patients included, 138 (48%) received tirofiban; 60(21%) IVT and 92(31%) oral antiplatelets. Median age was 63 (54-72) years, 65% were male, NIHSS at presentation was 5 (3-7). Baseline characteristics for each treatment group are summarized in the table. After adjusting by age, baseline mRS, NIHSS and time since onset, tirofiban was associated with higher odds of mRS 0-2 (93% vs 77%; aOR 3.7 [1.4-9.4]) and mRS 0-1(79% vs 59%; aOR 3.5 [1.7-6.9]). No sICH or severe systemic bleedings occurred in either group, minor bleedings included GI (T:1% vs ST:1%), hematuria (T:4% vs ST:0, p<0.01). Rate of neurological deterioration was T:0 vs ST:1%.
Tirofiban was associated with better outcomes irrespective of baseline NIHSS and control arm group (figure). Safety outcomes were not analyzed in subgroups due to low incidence of events.

Conclusion: Tirofiban is safe and may improve 90-day functional outcome in presumed non-embolic, non-LVO stroke, warranting further prospective randomized trials
  • Olive-gadea, Marta  ( Hospital Universitari Vall d'Hebron , Barcelona , Spain )
  • Behera, Usha Kiran  ( Lalitha hospitals , Guntut , India )
  • Geyik, Serdar  ( Aydin University, Florya MLP Stroke Center , Istanbul , Turkey )
  • Rizzo, Federica  ( Hospital Universitari Vall d'Hebron , Barcelona , Spain )
  • Rodrigo-gisbert, Marc  ( Hospital Universitari Vall d'Hebron , Barcelona , Spain )
  • Garcia-tornel Garcia-camba, Alvaro  ( Hospital Universitari Vall dHebron , Barcelona , Spain )
  • Muchada, Marian  ( Hospital Universitari Vall d'Hebron , Barcelona , Spain )
  • Simonetti, Renato  ( Hospital Universitari Vall d'Hebron , Barcelona , Spain )
  • Ribo, Marc  ( Hospital Universitari Vall d'Hebron , Barcelona , Spain )
  • Bajrami, Arsida  ( Aydin University, Florya MLP Stroke Center , Istanbul , Turkey )
  • Pamidimukkala, Vijaya  ( Lalitha hospitals , Guntut , India )
  • Flores, Alan  ( Hospital Joan XXIII , Tarragona , Spain )
  • Rubiera, Marta  ( Hospital Universitari Vall d'Hebron , Barcelona , Spain )
  • Aksoy, Sena  ( Aydin University, Florya MLP Stroke Center , Istanbul , Turkey )
  • Yelamanchi, Rama Chandra  ( Lalitha hospitals , Guntut , India )
  • Estrada, Edgardo  ( Hospital Universitari Vall d'Hebron , Barcelona , Spain )
  • Polavarapu, Naren  ( Lalitha hospitals , Guntut , India )
  • Author Disclosures:
    Marta Olive-Gadea: DO NOT have relevant financial relationships | Usha Kiran Behera: DO NOT have relevant financial relationships | serdar geyik: DO have relevant financial relationships ; Consultant:stryker:Active (exists now) ; Researcher:Rapidpulse:Active (exists now) ; Individual Stocks/Stock Options:Ceretrieve:Active (exists now) ; Consultant:Vesalio:Active (exists now) ; Consultant:Medtronic:Active (exists now) ; Consultant:Microvention:Active (exists now) | Federica Rizzo: DO NOT have relevant financial relationships | Marc Rodrigo-Gisbert: DO NOT have relevant financial relationships | Alvaro Garcia-Tornel Garcia-Camba: DO NOT have relevant financial relationships | Marian Muchada: DO NOT have relevant financial relationships | Renato Simonetti: DO NOT have relevant financial relationships | Marc Ribo: DO NOT have relevant financial relationships | Arsida Bajrami: DO NOT have relevant financial relationships | VIJAYA PAMIDIMUKKALA: DO NOT have relevant financial relationships | Alan Flores: DO NOT have relevant financial relationships | Marta Rubiera: DO have relevant financial relationships ; Consultant:Bayer:Active (exists now) | SENA AKSOY: DO NOT have relevant financial relationships | Rama Chandra YELAMANCHI: DO NOT have relevant financial relationships | Edgardo Estrada: No Answer | NAREN POLAVARAPU: No Answer
Meeting Info:
Session Info:

Acute Treatment: Systemic Thrombolysis and Cerebroprotection Moderated Digital Posters

Wednesday, 02/05/2025 , 12:40PM - 01:10PM

Moderated Digital Poster Abstract Session

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Clinical Determinants of Decision-Making for Extended-Window Intravenous Thrombolysis

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