In people with acute large artery atherosclerotic stroke and successful reperfusion after endovascular thrombectomy, using Tirofiban as an adjuvant improves functional outcome rate, without increasing rates of mortality or symptomatic intracranial hemorrhage.

A secondary analysis of a randomized clinical study sought to determine if giving adjunct intravenous Tirofiban in individuals having acute large artery atherosclerotic stroke is related to better outcomes after successful reperfusion.

Volunteers with intracranial big artery atherosclerotic stroke and an expanded Treatment in Cerebral Ischemia angiographic score (eTICI) of 2b50 to 3 were incorporated in this subgroup assessment of the RESCUE BT study. The variation in the proportion of independent functional outcome, characterized as a modified Rankin score of 0 to 2 at 90 days was the major endpoint ascertained. Symptomatic intracranial hemorrhage rates and ninety-day mortality were the safety outcomes.

Of the 382 subjects (median [IQR] age, 65 (55-72) years; 105 [27.5%] women) who had an intracranial major artery atherosclerotic stroke and successfully underwent reperfusion, 175 subjects (45.8%) received intravenous Tirofiban treatment, whereas 207 (54.2%) received a placebo. At 90 days, 54.3% (95/175) of individuals on Tirofiban had an independent functional outcome, compared to 44.0% (91/207) of those taking a placebo (adjusted odds ratio [aOR], 1.59).

Symptomatic intracranial hemorrhage within 48 hours (12/175 [6.9%] vs. 11/207 [5.3%]; aOR, 1.41) and 90-day mortality (21/175 [12.0] vs. 34/207 [16.4%]; aOR, 0.71) were not substantially raised by intravenous Tirofiban.

Adjunctive intravenous Tirofiban was related to a greater rate of independent functional outcome, but not with greater rates of mortality or intracranial hemorrhage among individuals suffering from stroke and successful reperfusion after endovascular thrombectomy.