Study on the timing selection of tirofiban application in endovascular treatment of atherosclerotic acute cerebral infarction and its relationship with prognosis

Wu Zhongyi; Yan Caiping; Sun Yuqin; Kong Yujuan

doi:10.3760/j.issn.1673-4777.2025.12.007

Abstract：Objective To investigate the efficacy of tirofiban at different time points in the endovascular treatment of atherosclerotic acute cerebral infarction(AIS)and its relationship with prognosis.Methods A total of 98 patients with atherosclerotic AIS who needed endovascular treatment in Shanxi Province Fenyang Hospital from June 2024 to May 2025 were selected as the research objects.All of the patients were divided into observation group[49 cases,tirofiban 0.4 μg/(kg·min)intravenous infusion for 0.5 h followed by 0.1 μg/(kg·min)intravenous infusion for 24 h+endovascular treatment]and control group[49 cases,tirofiban 0.2-1 mg during operation and 0.1 μg/(kg·min)intravenous infusion for 24 h after operation plus endovascular treatment]by random number table method.The platelet aggregation rate,platelet adhesion rate,platelet volume distribution width(PDW),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and National Institutes of Health Stroke Scale(NIHSS)scores were compared between the two groups at admission,24 h,7 d and 14 d after treatment.The rate of complications and good prognosis were compared between the two groups.Cox regression analysis was used to analyze the effect of tirofiban application time on the poor prognosis of patients.Results On admission,there were no significant differences in platelet aggregation rate,platelet adhesion rate,PDW,hs-CRP,IL-6,and NIHSS score between the two groups(all P＞0.05).After treatment,the platelet aggregation rate,platelet adhesion rate,PDW,hs-CRP,IL-6 and NIHSS score of the two groups were significantly decreased,and the observation group decreased more significantly at 7 d and 14 d after treatment(all P＜0.05).The incidence of reocclusion and the total incidence of adverse reactions in the observation group were significantly lower than those in the control group(all P＜0.05),and the rate of good prognosis was higher than that in the control group[73.5％(36/49)vs 51.0％(25/49)](P＜0.05).The timing of tirofiban administration in the observation group was a protective factor for the poor prognosis(hazard ratio=0.782,95％confidence interval:0.289-0.897,P=0.008),and the results were consistent in different subgroups.Conclusion The application of tirofiban before endovascular treatment can reduce the risk of poor prognosis of patients,and help to improve the neurological function,platelet function and inflammatory state of patients.