Effect of Intravenous Tirofiban vs Placebo Before Endovascular Thrombectomy on Functional Outcomes in Large Vessel Occlusion Stroke

医学 替罗非班 改良兰金量表 安慰剂 冲程(发动机) 随机对照试验 优势比 麻醉 入射(几何) 闭塞 内科学 外科 缺血 心肌梗塞 缺血性中风 机械工程 替代医学 病理 工程类 经皮冠状动脉介入治疗 物理 光学
作者
RESCUE BT Trial Investigators,Jie Shuai,Zili Gong,Li Huang,Juan Liu,Kun Tang,Zhenhui Duan,Houjie Ni,Yumin Liu,Fei Xie,Dongrun Yan,Songsheng Ye,Zhiquan Zhang,Zhihua Cao,Xianjin Shang,Xianhui Ding,Xiangjun Xu,Li Chen,Jiachuan Wu,Renliang Meng
出处
期刊:JAMA [American Medical Association]
卷期号:328 (6): 543-543 被引量:196
标识
DOI:10.1001/jama.2022.12584
摘要

Importance: Tirofiban is a highly selective nonpeptide antagonist of glycoprotein IIb/IIIa receptor, which reversibly inhibits platelet aggregation. It remains uncertain whether intravenous tirofiban is effective to improve functional outcomes for patients with large vessel occlusion ischemic stroke undergoing endovascular thrombectomy. Objective: To assess the efficacy and adverse events of intravenous tirofiban before endovascular thrombectomy for acute ischemic stroke secondary to large vessel occlusion. Design, Setting, and Participants: This investigator-initiated, randomized, double-blind, placebo-controlled trial was implemented at 55 hospitals in China, enrolling 948 patients with stroke and proximal intracranial large vessel occlusion presenting within 24 hours of time last known well. Recruitment took place between October 10, 2018, and October 31, 2021, with final follow-up on January 15, 2022. Interventions: Participants received intravenous tirofiban (n = 463) or placebo (n = 485) prior to endovascular thrombectomy. Main Outcomes and Measures: The primary outcome was disability level at 90 days as measured by overall distribution of the modified Rankin Scale scores from 0 (no symptoms) to 6 (death). The primary safety outcome was the incidence of symptomatic intracranial hemorrhage within 48 hours. Results: Among 948 patients randomized (mean age, 67 years; 391 [41.2%] women), 948 (100%) completed the trial. The median (IQR) 90-day modified Rankin Scale score in the tirofiban group vs placebo group was 3 (1-4) vs 3 (1-4). The adjusted common odds ratio for a lower level of disability with tirofiban vs placebo was 1.08 (95% CI, 0.86-1.36). Incidence of symptomatic intracranial hemorrhage was 9.7% in the tirofiban group vs 6.4% in the placebo group (difference, 3.3% [95% CI, -0.2% to 6.8%]). Conclusions and Relevance: Among patients with large vessel occlusion acute ischemic stroke undergoing endovascular thrombectomy, treatment with intravenous tirofiban, compared with placebo, before endovascular therapy resulted in no significant difference in disability severity at 90 days. The findings do not support use of intravenous tirofiban before endovascular thrombectomy for acute ischemic stroke. Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR-IOR-17014167.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
wanci应助yyyyy采纳,获得10
刚刚
li发布了新的文献求助20
刚刚
77完成签到,获得积分10
1秒前
1秒前
踏实口红完成签到,获得积分10
1秒前
小壳儿完成签到 ,获得积分10
2秒前
传奇3应助justonce采纳,获得10
2秒前
2秒前
天天发布了新的文献求助10
2秒前
liust完成签到,获得积分10
2秒前
2秒前
拼搏的依风完成签到 ,获得积分10
3秒前
3秒前
852应助meixinmeifei采纳,获得10
3秒前
4秒前
4秒前
沐言应助PEI采纳,获得10
4秒前
xusujuan完成签到,获得积分10
5秒前
5秒前
FashionBoy应助神经元neuron采纳,获得10
5秒前
赘婿应助okl采纳,获得10
5秒前
6秒前
6秒前
NeuroYan发布了新的文献求助10
6秒前
6秒前
7秒前
wqa1472完成签到,获得积分10
7秒前
schilling发布了新的文献求助30
8秒前
8秒前
8秒前
8秒前
LLL发布了新的文献求助10
9秒前
桃桃吖发布了新的文献求助10
9秒前
郭WL发布了新的文献求助20
11秒前
星辰大海应助heisa采纳,获得10
11秒前
11秒前
12秒前
Hello应助洋1采纳,获得10
12秒前
LLL发布了新的文献求助10
12秒前
完美世界应助711notfound采纳,获得10
12秒前
高分求助中
Principles of Economics, 11th Edition 10000
University Physics with Modern Physics, 16th edition 10000
(应助此贴封号)【重要!!请各用户(尤其是新用户)详细阅读】【科研通的精品贴汇总】 10000
48V Low-voltage Power Distribution Network (PDN) Architecture Industry Report, 2024 800
ズームレンズの光学設計に関する研究 800
Fundamentals of Pharmaceutical and Biologics Regulations: A Global Perspective, Second Edition 700
Matrix Methods in Data Mining and Pattern Recognition Second Edition 610
热门求助领域 (近24小时)
化学 材料科学 医学 生物 纳米技术 工程类 有机化学 化学工程 生物化学 计算机科学 内科学 物理 复合材料 催化作用 细胞生物学 无机化学 光电子学 物理化学 电极 基因
热门帖子
关注 科研通微信公众号,转发送积分 7294839
求助须知:如何正确求助?哪些是违规求助? 8913385
关于积分的说明 18872341
捐赠科研通 6961264
什么是DOI,文献DOI怎么找? 3210127
关于科研通互助平台的介绍 2379484
邀请新用户注册赠送积分活动 2186400