Tirofiban With Sequential Dual Antiplatelet Therapy in Mild Stroke

Korábbi kezelés

• Received or planned to receive intravenous thrombolysis or bridging therapy (with subsequent endovascular treatment)
• Major surgery within 14 days.

Más betegség

• Intracranial hemorrhage confirmed by imaging.
• Pre-stroke modified Rankin Scale (mRS) score ≥2.
• History of primary intracerebral hemorrhage.
• History of other intracranial hemorrhage (intraventricular, subarachnoid, epidural, or subdural hemorrhage).
• Major systemic bleeding within 30 days.
• Known allergy or contraindication to tirofiban or aspirin.
• Any terminal illness with life expectancy <6 months.

Laborértékek

• Any confirmed cardioembolic source, including chronic or paroxysmal atrial fibrillation, sick sinus syndrome, mitral stenosis, mechanical heart valve, infective endocarditis, intracardiac thrombus or vegetation, myocardial infarction within 3 months, dilated cardiomyopathy, left atrial spontaneous echo contrast, ejection fraction <30%.
• Active bleeding, including laboratory evidence of coagulopathy (platelet count <100 × 10⁹/L, activated partial thromboplastin time >50 seconds, or international normalized ratio >1.7), or treatment with direct oral anticoagulants within the preceding 48 hours.
• Baseline platelet count <100 × 10⁹/L.
• Severe renal dysfunction (glomerular filtration rate <30 mL/min or serum creatinine >220 μmol/L [2.5 mg/dL]).

Egyéb

• Untreated or inadequately treated intracranial aneurysm or vascular malformation.
• Persistently elevated blood pressure (systolic >180 mmHg or diastolic >110 mmHg) despite treatment.
• Current pregnancy or lactation.
• Any intracranial tumor (except asymptomatic meningiomas ≤1.5 cm in diameter).

• Age: 18-80 years old.
• Acute mild non-cardioembolic stroke.
• NIHSS score ≤5.
• Time from onset to randomization of ≤48 hours; if the time of onset is unknown, time from the last known time of being well to randomization of ≤48 hours.
• The investigational drug can be administered within 48 hours of symptom onset.
• Signed informed consent by the patient or legally authorized representative.