Objective To investigate the differences in efficacy and safety between tirofiban and aspirin in patients with acute ischemic stroke (AIS) and varying degrees of intracranial artery stenosis. Methods A total of 201 AIS patients were retrospectively enrolled and divided into a control group (oral aspirin enteric-coated tablets + clopidogrel bisulfate tablets, n=97) and an observation group (intravenous infusion of tirofiban injection, followed by oral aspirin enteric-coated tablets + clopidogrel bisulfate tablets, n=104) according to the actual treatment received. Patients in both groups were further stratified into three subgroups according to the severity of the culprit vessel stenosis: no stenosis, mild to moderate stenosis, and severe stenosis or arterial occlusion. Baseline characteristics, NIHSS scores before and after treatment, incidence of END, 90-day favorable prognosis rate, changes in platelet aggregation rate, and the occurrence of bleeding and death events were compared. Results Baseline characteristics were comparable between the two groups within each stenosis subgroup. After treatment, NIHSS scores and platelet aggregation rates significantly decreased in all subgroups compared to pre-treatment levels (P<0.05), and the scores in the observation group were significantly lower than those in the control group (P<0.05). In patients with severe stenosis or occlusion, the incidence of END was significantly lower and the 90-day favorable prognosis rate was significantly higher in the observation group compared to the control group (P<0.05). In contrast, no statistically significant differences were found in END incidence or favorable prognosis rate between the two groups for patients with no stenosis or mild to moderate stenosis. Regarding safety, there were no statistically significant differences in the incidence of systemic bleeding events or mortality between the two groups within any stenosis subgroup, and no symptomatic intracranial hemorrhage occurred in any group. Conclusion Tirofiban has significant efficacy and safety advantages in AIS patients with severe intracranial artery stenosis or occlusion, while its effects are comparable to aspirin in patients with non-severe stenosis.
Key words
intracranial artery stenosis /
acute ischemic stroke /
tirofiban /
aspirin /
early neurological deterioration
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