Clinical safety and possible efficacy of tirofiban in combination with intravenous thrombolysis by recombinant tissue plasminogen activator for early treatment of capsular warning syndrome (CWS)
The purpose of this study was to assess the efficacy and safety of the combination of tirofiban with intravenous thrombolysis (IVT) in treating patients with capsular warning syndrome (CWS) who failed to respond to the treatment of intravenous thrombolysis alone. Tirofiban was approved for the treat...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2022.1026127/full |
| _version_ | 1811225453907673088 |
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| author | Yunzhu Liu Shiyong Li Dongdong Hao Zhongping Zhang Yongxin Yi Jiayang Fang Weizhi Lin Min Zhang |
| author_facet | Yunzhu Liu Shiyong Li Dongdong Hao Zhongping Zhang Yongxin Yi Jiayang Fang Weizhi Lin Min Zhang |
| author_sort | Yunzhu Liu |
| collection | DOAJ |
| description | The purpose of this study was to assess the efficacy and safety of the combination of tirofiban with intravenous thrombolysis (IVT) in treating patients with capsular warning syndrome (CWS) who failed to respond to the treatment of intravenous thrombolysis alone. Tirofiban was approved for the treatment of CWS patients with fluctuating symptoms or no substantial improvement after intravenous thrombolysis within 24 h in our hospital from October 2019 to June 2021. Patients were evaluated with the National Institutes of Health Stroke Scale (NIHSS) at admission, at 72 h post-thrombolysis, at 1-week, and at 3-months with the modified Rankin Scales (MRS) score. A total of 12 patients received tirofiban and eight patients received control treatment with a history of CWS in our cohort. Among the patients, 13 patients smoked more than one pack of cigarettes a day, 17 had hypertension, 17 had hypercholesterolemia, 7 had diabetes, 1 had the history of cerebral infarction, 2 had atrial fibrillation, 7 had mild big vascular stenosis, 13 had lesions of the perforating branch by imaging, and 19 had acute capsular infarction. In both the tirofiban and control groups, NIHSS scores were significantly reduced after intravenous thrombolysis or 1-week after onset compared with before intravenous thrombolysis (P < 0.001). Before and after intravenous thrombolysis, there were no differences between the tirofiban group and control group (P = 0.970, P = 0.384, respectively). The tirofiban group, however, showed remarkably lower scores in both 1-week NIHSS and 3-month MRS than the control (P = 0.012, P = 0.003, respectively). Our study revealed that tirofiban did not increase the risk of hemorrhage and had favorable clinical efficacy as a remedial treatment for CWS patients with poor prognosis for intravenous thrombolysis, therefore indicating great potential for broader use. |
| first_indexed | 2024-04-12T09:07:27Z |
| format | Article |
| id | doaj.art-ad32d1b657b4404fbeb46b49a1ade963 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-04-12T09:07:27Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-ad32d1b657b4404fbeb46b49a1ade9632022-12-22T03:39:04ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2022-11-011610.3389/fnins.2022.10261271026127Clinical safety and possible efficacy of tirofiban in combination with intravenous thrombolysis by recombinant tissue plasminogen activator for early treatment of capsular warning syndrome (CWS)Yunzhu Liu0Shiyong Li1Dongdong Hao2Zhongping Zhang3Yongxin Yi4Jiayang Fang5Weizhi Lin6Min Zhang7Department of Encephalopathy, The Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, ChinaDepartment of Encephalopathy, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, ChinaDepartment of Outpatient, Lanzhou 7th Rest Center for Retired Cadre, Lanzhou, ChinaDepartment of Encephalopathy, The Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, ChinaDepartment of Encephalopathy, The Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, ChinaDepartment of Encephalopathy, The Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, ChinaDepartment of Encephalopathy, The Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, ChinaDepartment of Encephalopathy, The Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, ChinaThe purpose of this study was to assess the efficacy and safety of the combination of tirofiban with intravenous thrombolysis (IVT) in treating patients with capsular warning syndrome (CWS) who failed to respond to the treatment of intravenous thrombolysis alone. Tirofiban was approved for the treatment of CWS patients with fluctuating symptoms or no substantial improvement after intravenous thrombolysis within 24 h in our hospital from October 2019 to June 2021. Patients were evaluated with the National Institutes of Health Stroke Scale (NIHSS) at admission, at 72 h post-thrombolysis, at 1-week, and at 3-months with the modified Rankin Scales (MRS) score. A total of 12 patients received tirofiban and eight patients received control treatment with a history of CWS in our cohort. Among the patients, 13 patients smoked more than one pack of cigarettes a day, 17 had hypertension, 17 had hypercholesterolemia, 7 had diabetes, 1 had the history of cerebral infarction, 2 had atrial fibrillation, 7 had mild big vascular stenosis, 13 had lesions of the perforating branch by imaging, and 19 had acute capsular infarction. In both the tirofiban and control groups, NIHSS scores were significantly reduced after intravenous thrombolysis or 1-week after onset compared with before intravenous thrombolysis (P < 0.001). Before and after intravenous thrombolysis, there were no differences between the tirofiban group and control group (P = 0.970, P = 0.384, respectively). The tirofiban group, however, showed remarkably lower scores in both 1-week NIHSS and 3-month MRS than the control (P = 0.012, P = 0.003, respectively). Our study revealed that tirofiban did not increase the risk of hemorrhage and had favorable clinical efficacy as a remedial treatment for CWS patients with poor prognosis for intravenous thrombolysis, therefore indicating great potential for broader use.https://www.frontiersin.org/articles/10.3389/fnins.2022.1026127/fullcapsular warning syndrometirofibanintravenous thrombolysisacute ischemic strokeperforator occlusion |
| spellingShingle | Yunzhu Liu Shiyong Li Dongdong Hao Zhongping Zhang Yongxin Yi Jiayang Fang Weizhi Lin Min Zhang Clinical safety and possible efficacy of tirofiban in combination with intravenous thrombolysis by recombinant tissue plasminogen activator for early treatment of capsular warning syndrome (CWS) Frontiers in Neuroscience capsular warning syndrome tirofiban intravenous thrombolysis acute ischemic stroke perforator occlusion |
| title | Clinical safety and possible efficacy of tirofiban in combination with intravenous thrombolysis by recombinant tissue plasminogen activator for early treatment of capsular warning syndrome (CWS) |
| title_full | Clinical safety and possible efficacy of tirofiban in combination with intravenous thrombolysis by recombinant tissue plasminogen activator for early treatment of capsular warning syndrome (CWS) |
| title_fullStr | Clinical safety and possible efficacy of tirofiban in combination with intravenous thrombolysis by recombinant tissue plasminogen activator for early treatment of capsular warning syndrome (CWS) |
| title_full_unstemmed | Clinical safety and possible efficacy of tirofiban in combination with intravenous thrombolysis by recombinant tissue plasminogen activator for early treatment of capsular warning syndrome (CWS) |
| title_short | Clinical safety and possible efficacy of tirofiban in combination with intravenous thrombolysis by recombinant tissue plasminogen activator for early treatment of capsular warning syndrome (CWS) |
| title_sort | clinical safety and possible efficacy of tirofiban in combination with intravenous thrombolysis by recombinant tissue plasminogen activator for early treatment of capsular warning syndrome cws |
| topic | capsular warning syndrome tirofiban intravenous thrombolysis acute ischemic stroke perforator occlusion |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2022.1026127/full |
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