Factors affecting the outcomes of tirofiban treatment in posterior circulation stroke

Objective: Tirofiban is an effective treatment for ischemic stroke that is frequently used following early neurological deterioration (END). However, studies investigating the effects of tirofiban on patients with posterior circulation stroke (PCS) are scarce. Thus, this study aimed to explore factors affecting the outcomes of tirofiban in PCS.

Methods: The data of patients with PCS treated with tirofiban at our hospital were retrospectively collected. A modified Rankin scale (mRS) of 0-2 at 90 days was defined as a favorable outcome. A reduction in NIHSS after treatment compared with baseline NIHSS was defined as an early response to tirofiban. Patients' clinical characteristics and laboratory findings were analyzed to identify independent factors affecting the outcomes of tirofiban treatment.

Results: A total of 113 patients were enrolled in this study. 71 patients (62.8 %) exhibited favorable outcomes, whereas the remaining patients (37.2 %) had unfavorable outcomes. Hypertension and high NIHSS at admission were associated with unfavorable outcomes [(OR: 0.151, 95 % CI: 0.026-0.872; p = 0.035), (OR: 0.645, 95 % CI: 0.491-0.847; p < 0.001)], whereas high early response to tirofiban was significantly associated with favorable outcomes (OR: 1.913, 95 %CI: 1.390-2.631; p < 0.001). The cut-off value of early response to tirofiban to predict a favorable outcome was 0.5, with a sensitivity and specificity of 69 % and a Youden index of 0.38.

Conclusion: Early response to tirofiban had the highest predictive value on long-term outcomes of PCS patients treated with tirofiban.