Abstract P221: Effects of Immediate Antihypertensive Treatment in Men and Women with Acute Ischemic Stroke: The CATIS Study

Gender difference in the risk and prognosis of ischemic stroke has been reported. We examined the effects of immediate antihypertensive treatment on clinical outcomes among acute ischemic stroke by gender in the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). CATIS was a randomized, single-blind, and blinded end-point trial conducted in 4,071 acute ischemic stroke patients (2,604 men and 1,467 women). Eligible stroke patients with elevated systolic blood pressure (SBP) were randomly assigned to receive antihypertensive treatment (lowering SBP by 10-25% within the first 24 hours after randomization and BP < 140/90 mm Hg within 7 days) or control (discontinuing all antihypertensive medications). The primary outcome was a combination of death and major disability (defined by a modified Rankin score ≥ 3) at day 14 (or at discharge if earlier than 14 days) and 3-month post-treatment follow-up. The primary outcome was not significantly different between the treatment and control groups in either men or women. The primary outcome event rates for the two comparison groups were 31.6% and 32.1% in men ( P = 0.79) and 37.3% and 36.1% in women ( P = 0.65) at day 14; and were 23.6% and 24.5% in men ( P = 0.60) and 28.0% and 26.6% in women ( P = 0.56) at 3-month follow-up. The secondary outcomes were not different between treatment and control groups among men and women at 14 days or hospital discharge and at 3 months. The median modified Rankin scores (interquartile range) for the comparison groups were 2.0 (1.0-3.0) and 2.0 (1.0-3.0) in both men and women at day 14 or hospital discharge. The modified Rankin score, recurrent stroke, vascular event, and all-cause mortality at 3-month follow-up were similar between the treatment and control groups for both men and women. For example, the vascular event rates for the comparison groups were 2.4% and 3.0% in men ( P = 0.34) and 2.4% and 2.9% in women ( P = 0.58). There were no significant treatment and sex interactions for any of the primary and secondary outcomes. In conclusion, these data suggest that immediate antihypertensive treatment within the first 48 hours after stroke onset has no gender-specific effect on short-term outcomes of patients with acute ischemic stroke.

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Early Blood Pressure Reduction in Acute Ischemic Stroke with Various Severities: A Subgroup Analysis of the CATIS Trial

Cerebrovascular Diseases ◽

10.1159/000444722 ◽

2016 ◽

Vol 42 (3-4) ◽

pp. 186-195 ◽

Cited By ~ 6

Author(s):

Xiaoqing Bu ◽

Changwei Li ◽

Yonghong Zhang ◽

Tan Xu ◽

Dali Wang ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Subgroup Analysis ◽

Recurrent Stroke ◽

Control Groups ◽

Vascular Events ◽

Nihss Score ◽

Comparison Groups ◽

And Control

Background: Clinical trials have generally showed a neutral effect of blood pressure (BP) reduction on clinical outcomes among acute ischemic stroke patients. We conducted a prespecified subgroup analysis to assess whether disease severity modifies the effect of early antihypertensive treatment on death and disability among patients with acute ischemic stroke. Methods: In the China Antihypertensive Trial in Acute Ischemic Stroke, 4,071 patients with acute ischemic stroke and elevated BP were randomly assigned to receive antihypertensive treatment or to discontinue all hypertension medications within 48 h of symptom onset. The primary outcome was a combination of death and major disability at 14 days or hospital discharge. In this subgroup analysis, participants were categorized into 3 groups according to their baseline NIH Stroke Scale (NIHSS) scores (0-4, 5-15, or ≥16). Results: At 24 h after randomization, mean systolic BP differences (95% CIs) were -8.5 (-10.0 to -7.1), -9.8 (-11.4 to -8.3), and -9.1 (-14.4 to -3.8) mm Hg between the treatment and control groups (all p values <0.001) for patients with a baseline NIHSS score of 0-4, 5-15, and ≥16, respectively. At day 7 after randomization, the corresponding mean systolic BP differences were -9.3 (-10.5 to -8.2), -9.1 (-10.3 to -7.8), and -10.1 (-15.1 to -5.1) mm Hg between the treatment and control groups (all p values <0.001). The primary outcome was not significantly different between the treatment and control groups at day 14 or hospital discharge among all NIHSS subgroups (p value for homogeneity = 0.66). ORs (95% CI) associated with treatment were 1.14 (0.87-1.49, p = 0.33), 1.04 (0.86-1.25, p = 0.70), and 0.67 (0.18-2.44, p = 0.54) for patients with a baseline NIHSS score of 0-4, 5-15, and ≥16, respectively. The composite outcome of death and major disability at 3-month follow-up did not differ between the 2 comparison groups for all NIHSS subgroups. In addition, vascular events and recurrent stroke were not significantly different between the 2 comparison groups at the 3-month follow-up visit among all NIHSS subgroups except that there was a suggestive risk reduction for recurrent stroke among those with an NIHSS score of 5-15 (OR 0.45, 95% CI 0.20-0.99, p = 0.05). Conclusion: Early BP reduction with antihypertensive medications did not reduce or increase the risk of death, major disabilities, recurrent instances of stroke, and vascular events in acute ischemic stroke patients with a variety of disease severities.

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Clinical Impact of Estradiol/Testosterone Ratio in Patients with Acute Ischemic Stroke

10.21203/rs.3.rs-33503/v3 ◽

2020 ◽

Author(s):

Jung-Won Choi ◽

In Woo Ryoo ◽

Jun Yeong Hong ◽

Kyung-Yul Lee ◽

Hyo Suk Nam ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Sex Hormones ◽

Control Group ◽

Control Groups ◽

Sexual Hormones ◽

Stroke Group ◽

Male Patients ◽

And Control

Abstract Background: Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS).Methods: Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients.Results: The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003).Conclusions: These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.

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Abstract 65: Effects of Immediate Blood Pressure Reduction on Two-Year Mortality and Major Disability in Patients With Acute Ischemic Stroke

Stroke ◽

10.1161/str.48.suppl_1.65 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Jiang He ◽

Yonghong Zhang ◽

Tan Xu ◽

Dali Wang ◽

Chung-Shiuan Chen ◽

...

Keyword(s):

Blood Pressure ◽

Ischemic Stroke ◽

Treatment Group ◽

Acute Ischemic Stroke ◽

Antihypertensive Treatment ◽

Blood Pressure Reduction ◽

Control Group ◽

Antihypertensive Medications ◽

Vascular Events

Although elevated blood pressure (BP) is very common in patients with acute ischemic stroke, the management of hypertension among them remains controversial. We tested the effect of immediate BP reduction on two-year mortality and major disability in acute ischemic stroke patients. The China Antihypertensive Trial in Acute Ischemic Stroke, a randomized, single-blind, blinded end-points trial, was conducted in 4,071 patients with ischemic stroke within 48 hours of onset and elevated systolic BP (SBP). Patients were randomly assigned to receive antihypertensive treatment (n=2,038) or to discontinue all antihypertensive medications (n=2,033) during hospitalization. Post-treatment follow-ups were conducted at 3, 12, and 24 months after hospital discharge. The primary outcome was a composite of death and major disability at the two-year follow-up visit. Mean SBP was reduced by 21.8 in the treatment group and 12.7 mm Hg in the control group within 24 hours after randomization (P<0.001). Mean SBP was 137.3 mm Hg in the treatment group and 146.5 in the control group at day 7 after randomization (P<0.001). At two-year follow-up, study outcomes were obtained in 1945 (95.4%) participants in the treatment group and 1925 (94.7%) in the control group. 78.8% of the patients in the treatment group and 72.6% in the control group reported the use of antihypertensive medications (p<0.001). SBP was 138.8 mmHg in the antihypertensive treatment group and 139.7 in the control group (p=0.02). Among patients in the antihypertensive treatment group, 24.5% (476/1945) died or had a major disability, compared with 22.1% (425/1925) in the control group (odds ratio 1.14 [95% CI 0.99 to 1.33], p=0.078). Hazard ratios for all-cause mortality (1.01 [0.81, 1.25], p=0.95), recurrent stroke (0.91 [0.73, 1.13], p=0.40), and vascular events (0.97 [0.79, 1.19], p=0.76) were not statistically significant comparing the antihypertensive treatment group to the control group. The effect of antihypertensive treatment did not differ by pre-defined subgroups. In conclusion, among patients with acute ischemic stroke, BP reduction with antihypertensive medications during hospitalization did not reduce or increase the composite outcome of death and major disability over two years.

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Clinical Impact of Estradiol/Testosterone Ratio in Patients with Acute Ischemic Stroke

10.21203/rs.3.rs-33503/v4 ◽

2020 ◽

Author(s):

Jung-Won Choi ◽

In Woo Ryoo ◽

Jun Yeong Hong ◽

Kyung-Yul Lee ◽

Hyo Suk Nam ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Sex Hormones ◽

Control Group ◽

Control Groups ◽

Sexual Hormones ◽

Stroke Group ◽

Male Patients ◽

And Control

Abstract Background: Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS). Methods: Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients.Results: The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003).Conclusions: These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.

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Clinical Impact of Estradiol/Testosterone Ratio in Patients with Acute Ischemic Stroke

10.21203/rs.3.rs-33503/v2 ◽

2020 ◽

Author(s):

Jung-Won Choi ◽

In Woo Ryoo ◽

Jun Yeong Hong ◽

Kyung-Yul Lee ◽

Hyo Suk Nam ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Sex Hormones ◽

Control Group ◽

Control Groups ◽

Sexual Hormones ◽

Stroke Group ◽

Male Patients ◽

And Control

Abstract Background: Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS). Methods: Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients.Results: The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003).Conclusions: These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.

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Clinical impact of estradiol/testosterone ratio in patients with acute ischemic stroke

BMC Neurology ◽

10.1186/s12883-021-02116-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jung-Won Choi ◽

In Woo Ryoo ◽

Jun Yeong Hong ◽

Kyung-Yul Lee ◽

Hyo Suk Nam ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Sex Hormones ◽

Control Group ◽

Control Groups ◽

Sexual Hormones ◽

Stroke Group ◽

Male Patients ◽

And Control

Abstract Background Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS). Methods Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients. Results The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003). Conclusions These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.

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Association of Plasma Metabolic Biomarker Sphingosine-1-Phosphate With Cerebral Collateral Circulation in Acute Ischemic Stroke

Frontiers in Physiology ◽

10.3389/fphys.2021.720672 ◽

2021 ◽

Vol 12 ◽

Author(s):

Fang Yu ◽

Xianjing Feng ◽

Xi Li ◽

Zeyu Liu ◽

Di Liao ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Collateral Circulation ◽

Sphingolipid Metabolism ◽

Healthy Controls ◽

Control Groups ◽

Sphingosine 1 Phosphate ◽

Discovery Stage ◽

Significant Pathway ◽

And Control

Background: The contribution of metabolic profile to the cerebral collateral circulation in acute ischemic stroke (AIS) has not been fully outlined. In this study, we conducted a metabolomic study to assess the relationship between the metabolic biomarkers and the collateral status of AIS.Methods: A two-stage study was conducted from September 2019 to June 2021 in our hospital. There were 96 subjects including 66 patients with AIS and 30 healthy controls in the discovery stage and 80 subjects including 53 patients with AIS and 27 healthy controls in the validation stage. Collateral circulation was assessed by the Tan score based on computed tomographic angiography (CTA). Liquid chromatography-tandem mass spectrometry was used to identify differential metabolic markers. Then, an ELISA was employed to detect the plasma levels of sphingosine-1-phosphate (S1P).Results:There were 114 differential metabolites between patients with AIS and control groups and 37 differential metabolites between good collateral circulation (GCC) and poor collateral circulation (PCC) groups. The pathway enrichment analysis revealed that arginine biosynthesis was the only statistically significant pathway between AIS and control groups and sphingolipid metabolism was the only statistically significant pathway between GCC and PCC groups. The differential metabolites sphinganine-1-phosphate (SA1P) and S1P belong to the sphingolipid metabolism. In the discovery stage, when the GCC group was compared with the PCC group, the receiver operating characteristic (ROC) analysis showed that plasma SA1P relative levels demonstrated an area under the curve (AUC) of 0.719 (95% CI: 0.582–0.834), and S1P levels demonstrated an AUC of 0.701 (95% CI: 0.567–0.819). In addition, both plasma SA1P and S1P relative levels showed significant negative correlations with the 90-day modified Rankin Scale (mRS) score. In the validation sample, higher plasma S1P levels were independent predictors of GCC (p = 0.014), and plasma S1P levels demonstrated an AUC of 0.738 (95% CI: 0.599–0.849) to differentiate patients with GCC from patients with PCC. In addition, plasma S1P levels also showed significant negative correlations with the 90-day mRS score.Conclusion: We first illustrated the association between plasma metabolic profiles and cerebral collateral circulation in patients with AIS. Plasma S1P levels might be a potential diagnostic biomarker for predicting collateral circulation status in patients with AIS.

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Abstract P212: Blood pressure lowering and clinical outcomes in patients with acute ischemic stroke: China Antihypertensive Trial in Acute Ischemic Stroke (CATIS)

Circulation ◽

10.1161/circ.129.suppl_1.p212 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Jiang He ◽

Yonghong Zhang ◽

Tan Xu ◽

Qi Zhao ◽

Chung-Shiuan Chen ◽

...

Keyword(s):

Blood Pressure ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Clinical Outcomes ◽

Hospital Discharge ◽

Antihypertensive Treatment ◽

Stroke Onset ◽

Odds Ratios ◽

Risk Of Death

Introduction: Observational studies have reported that a decrease in blood pressure (BP) within the first several days after stroke onset was associated with poorer, better, or no difference in adverse clinical outcomes among patients with acute ischemic stroke. Hypothesis: We investigated the association of immediate BP lowering in acute ischemic stroke patients with major clinical outcomes at 14 days or hospital discharge and at a 3 month follow-up visit. Methods: CATIS is a randomized clinical trial conducted in 4,071 Chinese patients with ischemic stroke within 48 hours of onset and elevated systolic BP (SBP). Patients were randomly assigned to receive antihypertensive treatment or control. The primary outcome was a combination of death and major disability (a modified Rankin score ≥3) at 14 days or hospital discharge or at the 3 month follow-up visit. Multiple logistic regression analysis was used to adjust for baseline age, gender, SBP, NIHSS score, time of stroke onset, history of antihypertensive treatment, and intervention assignment. Results: Compared to patients with a >0-10% reduction in systolic BP within the first 24 hours after admission, the multivariable-adjusted odds ratios (95% confidence interval [CI]) for patients with ≤0%, 11-20%, and ≥21% reduction in SBP were 1.40 (1.08, 1.82), 1.00 (0.81, 1.23), and 0.98 (0.73, 1.30) at 14 days or hospital discharge; and 1.31 (1.00, 1.71), 0.82 (0.66, 1.02), and 0.78 (0.58, 1.05) at 3 months follow-up. Compared to patients with a BP 130-139/85-89 mmHg at 7 days after admission, the multivariable-adjusted odds ratios (95% CI) for patents with BP <130/85, 140-159/90-99, and ≥160/100 mmHg were 1.07 (0.82, 1.38), 1.09 (0.89, 1.34), and 1.58 (1.18, 2.11) at 14 days or hospital discharge, and 0.89 (0.67, 1.17), 1.10 (0.89, 1.36), and 1.50 (1.11, 2.03) at 3 months follow-up, respectively. Conclusions: These data indicate that a lack of BP reduction in the first 24 hours of hospitalization and higher BP levels at 7 days after admission predict increased risk of death and major disability at 14 days or hospital discharge and at 3 months follow-up.

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Abstract P174: Effects of Immediate Blood Pressure Reduction on Death and Major Disability in Acute Ischemic Stroke Patients According to Time from Onset to Treatment

Circulation ◽

10.1161/circ.131.suppl_1.p174 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Tan Xu ◽

Yonghong Zhang ◽

Yingxian Sun ◽

Chung-Shiuan Chen ◽

Jing Chen ◽

...

Keyword(s):

Ischemic Stroke ◽

Treatment Group ◽

Acute Ischemic Stroke ◽

Hospital Discharge ◽

Odds Ratio ◽

Antihypertensive Treatment ◽

Recurrent Stroke ◽

Stroke Onset ◽

Vascular Events

Introduction: Although elevated blood pressure (BP) is very common in patients with acute ischemic stroke, the management of hypertension among them remains controversial. Hypothesis: We tested the effects of immediate BP reduction on death and major disability at 14 days or hospital discharge and 3-month follow-up in patients with acute ischemic stroke according to time from stroke onset to initiation of antihypertensive treatment (<12, 12-23, and ≥24 hours). Methods: The China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) randomly assigned patients with ischemic stroke within 48 hours of onset and elevated systolic BP (SBP) to receive antihypertensive treatment (N=2,038) or to discontinue all antihypertensive medications (N=2,033) during hospitalization. Study outcomes were assessed at 14 days or hospital discharge and 3-month post-treatment follow-up. The primary outcome was death and major disability (modified Rankin Scale score≥3), and secondary outcomes included recurrent stroke and vascular events. Results: Mean SBP was reduced 12.7% in the antihypertensive treatment group and 7.2% in the control group within 24 hours after randomization (P<0.001). Mean SBP was 137.3 mmHg in the antihypertensive treatment group and 146.5 in the control group at day 7 after randomization (P<0.001). At 14 days or hospital discharge, the primary and secondary outcomes were not significantly different between treatment and control groups according to time from onset to treatment. At the 3-month follow-up, death or major disability (odds ratio 0.73, 95% CI 0.55-0.97, p=0.03), recurrent stroke (odds ratio 0.24, 95% CI 0.08-0.72, p=0.01), and vascular events (odds ratio 0.41, 95% CI 0.18-0.96, p=0.04) were significantly reduced in the antihypertensive treatment group among participants with time from stroke onset to treatment initiation ≥24 hours only. Conclusion: Among patients with acute ischemic stroke, BP reduction with antihypertensive medications might reduce 3-month death and major disability, recurrent stroke, and vascular events among those who initiated antihypertensive treatment after 24 hours from stroke onset.

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The Safety and Efficiency of Tirofiban in Acute Ischemic Stroke Patients Treated with Mechanical Thrombectomy: A Multicenter Retrospective Cohort Study

Biochemistry Research International ◽

10.1155/2020/5656173 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Lili Zhao ◽

Yating Jian ◽

Tao Li ◽

Heying Wang ◽

Zhang Lei ◽

...

Keyword(s):

Ischemic Stroke ◽

Intracerebral Hemorrhage ◽

Acute Ischemic Stroke ◽

Mechanical Thrombectomy ◽

Cox Regression ◽

Functional Independence ◽

Control Group ◽

Symptomatic Intracerebral Hemorrhage ◽

And Control

Introduction. Limited comparative studies have reported the safety and efficacy of tirofiban in acute ischemic stroke (AIS) patients after mechanical thrombectomy (MT). Additionally, the available studies are inconsistent with each other, which makes application of tirofiban unclear in neuro-intervention. Here, we performed a comparative retrospective study to investigate whether tirofiban combined with MT improves short- and long-term prognosis in AIS patients and whether its use is associated with complications. Method. Retrospective data were collected for AIS patients admitted between January 2013 and January 2019 at three stroke centers. According to whether tirofiban was used during the operation, patients were divided into tirofiban group and control group. Multivariate and COX regression analyses were performed to determine the association of tirofiban treatment with safety and efficiency in subjects treated with MT. Result. A total of 174 patients were analyzed, of whom 89 (51.1%) were treated with tirofiban. There were no differences in the incidence of symptomatic intracerebral hemorrhage (10.2% vs. 10.6%, p=0.918), parenchymal hemorrhage type 2 (18.0% vs. 16.5%, p=0.793), and reocclusion at 24 h (3.4% vs. 10.6%, p=0.060) between the tirofiban group and control group. Multivariate regression showed that tirofiban was not associated with intracerebral hemorrhage, early neurological deterioration, neurological improvement at 7 days, functional independence at 3-month and 9-month follow-up, or death at 9-month follow-up (adjusted p>0.05 for all). However, AIS patients treated with MT + tirofiban showed a trend towards acquiring faster functional independence, with a median time to acquire functional independence of 4.0 months compared with 6.5 months in the control group (risk ratio = 1.49, 95% confidence interval 0.98–2.27; long rank p=0.066). Conclusion. Tirofiban may help AIS patients given MT to gain functional independence faster, without increasing the risk of complications.

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