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Войти в исследования Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2026
Effect of intravenous tirofiban on the radiologic classification of intracranial hemorrhage after endovascular treatment in acute anterior circulation occlusive stroke: results from the RESCUE BT trial.
СтатьяРандомизированное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Peng Feng, Zhang Chunzhen, Li Shuiwen, Zi Wenjie, Guo Changwei, Peng Zhouzhou, Xiao Yun, Fan Shitao, Li Fengli
Аннотация
PURPOSES: Intracranial hemorrhage (ICH) is a serious complication after endovascular treatment (EVT) for large vessel occlusive stroke. Using data from RESCUE BT, we aimed to investigate the relationship between intravenous tirofiban preceding EVT and radiologic ICH subtypes in acute large vessel occlusion of anterior circulation undergoing EVT.
METHODS: Patients were randomly assigned in a 1:1 ratio to receive intravenous tirofiban or placebo before EVT. Radiologic ICH subtypes according to the Heidelberg bleeding classification, including hemorrhagic infarction type 1 (HI-1), hemorrhagic infarction type 2 (HI-2), parenchymal hematoma type 1 (PH-1), parenchymal hematoma type 2 (PH-2) and Extra-parenchymal hemorrhage, were evaluated through follow-up imaging. A Poisson regression analysis was performed to identify the association between tirofiban and radiologic ICH subtypes. Factors modifying the tirofiban effect on ICH subtypes were exploratorily analyzed.
RESULTS: The radiologic ICH developed in 296 (31.3%) of 945 included patients. In patients with ICH, HI-1 occurred in 28 (3.0%), HI-2 in 124 (13.1%), PH-1 in 48 (5.1%), PH-2 in 57 (6.0%) and Extra-parenchymal hemorrhage in 39 (4.1%). After adjusting for confounders, tirofiban treatment was strongly associated with increased risk of PH-2 (adjusted relative risk [RR] 1.77, 95% CI 1.04-3.03, P=0.036) and any radiologic ICH (adjusted RR 1.25, 95% CI 1.04-1.51, P=0.018) compared with placebo. Exploratory analyses found cardioembolic stroke (Pinteraction =0.031) harbored a higher PH-2 risk when they received tirofiban treatment.
CONCLUSIONS: Intravenous tirofiban preceding EVT significantly increased PH-2 risk in large vessel occlusive stroke. Cardioembolic stroke might be associated with PH-2 risk for patients receiving tirofiban before EVT.
METHODS: Patients were randomly assigned in a 1:1 ratio to receive intravenous tirofiban or placebo before EVT. Radiologic ICH subtypes according to the Heidelberg bleeding classification, including hemorrhagic infarction type 1 (HI-1), hemorrhagic infarction type 2 (HI-2), parenchymal hematoma type 1 (PH-1), parenchymal hematoma type 2 (PH-2) and Extra-parenchymal hemorrhage, were evaluated through follow-up imaging. A Poisson regression analysis was performed to identify the association between tirofiban and radiologic ICH subtypes. Factors modifying the tirofiban effect on ICH subtypes were exploratorily analyzed.
RESULTS: The radiologic ICH developed in 296 (31.3%) of 945 included patients. In patients with ICH, HI-1 occurred in 28 (3.0%), HI-2 in 124 (13.1%), PH-1 in 48 (5.1%), PH-2 in 57 (6.0%) and Extra-parenchymal hemorrhage in 39 (4.1%). After adjusting for confounders, tirofiban treatment was strongly associated with increased risk of PH-2 (adjusted relative risk [RR] 1.77, 95% CI 1.04-3.03, P=0.036) and any radiologic ICH (adjusted RR 1.25, 95% CI 1.04-1.51, P=0.018) compared with placebo. Exploratory analyses found cardioembolic stroke (Pinteraction =0.031) harbored a higher PH-2 risk when they received tirofiban treatment.
CONCLUSIONS: Intravenous tirofiban preceding EVT significantly increased PH-2 risk in large vessel occlusive stroke. Cardioembolic stroke might be associated with PH-2 risk for patients receiving tirofiban before EVT.