Safety and Efficacy of Tirofiban During Mechanical Thrombectomy for Stroke Patients with Preceding Intravenous Thrombolysis

Figures & data

Table 1 Baseline Characteristics of Patients Underwent MT Therapy and Preceding Intravenous Thrombolysis

Characteristics	All Patients (n=207)	Tirofiban n=55	Non-Tirofiban n=152	P value
Age, mean± SD	63.9±13.8	62.5±16.9	64.4±12.5	0.87
Male, (n%)	142 (68.6)	38 (69.1)	104 (68.4)	0.93
ASPECTS ^a, median(IQR)	8 (8–8)	8 (7–8)	8 (8–9)	0.55
Admission NIHSS, median (IQR)	16 (12–20)	18 (13–22)	15 (12–20)	0.03
OTP time, median (IQR), min	240 (180–310)	265 (190–330)	240 (180–295)	0.15
OTR time, median (IQR), min	322 (268–397)	355 (290–435)	320 (260–388)	0.21
Pre-antiplatelet (n%)	32 (15.5)	22 (14.5)	10 (18.2)	0.51
Vascular risk factors (n%)
Previous ischemic stroke	27 (13.0)	9 (16.4)	18 (11.8)	0.39
Hypertension	109 (52.7)	31 (56.4)	78 (51.3)	0.52
Diabetes mellitus	31 (15.0)	10 (18.2)	21 (13.8)	0.44
Atrial fibrillation	40 (19.3)	5 (9.1)	35 (23.0)	0.03
Moderate to heavy alcohol consumption	84 (40.6)	26 (47.3)	58 (38.2)	0.24
Previous or current smoker	73 (35.3)	27 (49.1)	46 (30.3)	0.01
Pathogenesis of stroke, (n%)
Large artery atherosclerosis	138 (66.7)	40 (72.7)	98 (64.5)	0.27
Cardio-embolism	42 (20.3)	9 (16.4)	33 (21.7)	0.40
Other	27 (13.0)	6 (10.9)	21 (13.8)	0.58
Anterior circulation stroke (n%)	178 (86.0)	44 (80.0)	134 (88.2)	0.14
Posterior circulation stroke (n%)	29 (14.0)	11 (20.0)	18 (11.8)
Operation procedures (n%)
Intra-arterial thrombolysis	41 (19.8)	17 (30.9)	24 (15.8)	0.02
Balloon angioplasty	25 (12.1)	13 (23.6)	12 (7.9)	<0.01
Permanent stenting	22 (10.6)	10 (18.2)	12 (7.9)	0.03
Intracranial stenting	6 (27.3)	2 (33.3)	4 (66.7)	0.65
Extracranial stenting	16 (72.7)	8 (5.00)	8 (50.0)
Heparin during MT ^b (n%)	85 (41.5)	27 (49.1)	58 (38.7)	0.18

Notes: ^aASPECTS score for anterior circulation stroke only. ^bHeparin during MT for 205 patients.

Abbreviations: IQR, interquartile range; IVT, intravenous thrombolysis; ASPECTS, Alberta Stroke Program Early CT Score; NIHSS, National Institutes of Health Stroke Scale score; OTP time, onset to puncture time; OTR time, onset to recanalization time; MT, mechanical thrombectomy.

Figure 1 Flowchart.

Table 2 Safety and Efficacy Endpoints of MT Patients with Preceding Intravenous Thrombolysis Grouped by Tirofiban Use

	All	Tirofiban n=55	Non-Tirofiban n=152	OR^a/HR^b (95% CI)	P value	Adjusted OR^a/HR^b (95% CI)	Adjusted P value
Safety outcomes
sICH	17 (8.2)	6 (10.9)	11 (7.2)	1.57 (0.55–4.47)	0.40	1.85 (0.56–6.16)	0.32
Total ICH	36 (17.4)	10 (18.2)	26 (17.1)	1.08 (0.48–2.41)	0.86	1.42 (0.56–3.65)	0.46
Distal embolization	11 (5.3)	5 (9.1)	6 (4.0)	2.43 (0.71–8.32)	0.15	3.45 (0.86–13.76)	0.08
Efficacy outcomes
Recanalization	181 (87.4)	46 (83.6)	135 (88.8)	0.64 (0.27–1.54)	0.32	0.93 (0.45–1.94)	0.85
3-month functional independence	111 (53.6)	27(49.1)	84 (55.3)	0.78 (0.42–1.45)	0.43	0.75 (0.27–2.04)	0.57
3-month mortality	34 (16.4)	4 (7.3)	30 (19.7)	0.32 (0.11–0.95)	0.03	0.28 (0.08–0.94)	0.03

Notes: Adjusted for age, gender, admission NIHSS score, smoking, atrial fibrillation, operative procedures (intra-arterial thrombolysis, balloon angioplasty and permanent stenting). ^aOR or adjusted OR for recanalization, total ICH, sICH, distal embolization of thrombus and long-term functional independence. ^bHR or adjusted HR for long-term mortality.

Abbreviations: OR, odds ratio; HR, hazard ratio; sICH, symptomatic intracranial hemorrhage; Functional independence, mRS 0–2.

Figure 2 Distributions of the 3-month modified Rankin Scale score (mRS) of patients who underwent mechanical thrombectomy and preceding intravenous thrombolysis.