Efficacy and Safety of Tirofiban in Patients with Acute branch atheromatous disease after intravenous thrombolysis

Background and purpose Acute branch atheromatous disease (BAD) frequently leads to early neurological deterioration (END), a factor that often predicts an unfavorable outcome. Our study aimed to assess evaluate efficacy and safety of intravenous tirofiban for improving the functional outcome in patients with acute BAD after intravenous thrombolysis. Methods In this retrospective study, acute BAD patients who received intravenous thrombolysis followed by tirofiban between January 2019 and December 2023 were enrolled. The demographics, clinical data, and functional outcomes were compared among different groups. A modified ranking scale (mRS) ≤ 2 was defined as favorable outcome at 90 days. The safety outcome was the incidence of any intracranial hemorrhage and tirofiban-associated complications. Results A total of 111 patients were included, 32(28.83%) patients experienced END, 34(30.63%) patients received tirofiban after thrombolysis, tirofiban was independently associated with favorable prognosis (aOR, 6.55; 95%CI, 1.10-39.15; P = 0.039) for acute BAD patients with intravenous thrombolysis at 90 days, there was no statistical difference in safety between the tirofiban and no tirofiban groups (P > 0.05). Conclusions Tirofiban had shown promising potential as an adjunctive therapy in acute BAD patients who received intravenous thrombolysis. Tirofiban was associated with improved clinical outcomes without increasing any bleeding risks and tirofiban-associated complications