Abstract Details

Title Intravenous Tirofiban in Acute Non-cardioembolic Stroke: Preventing Early Neurological Deterioration – A Narrative Review

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-017

Objective To evaluate the clinical efficacy, safety, and therapeutic potential of intravenous tirofiban in preventing early neurological deterioration among patients with non-cardioembolic acute ischemic stroke.

Background Acute non-cardioembolic stroke, a major subtype of acute ischemic stroke (AIS), remains a leading global cause of disability and death. Although reperfusion therapies such as intravenous thrombolysis and mechanical thrombectomy have improved outcomes, many patients still experience early neurological deterioration (END). Current therapeutic options are limited by narrow time windows, hemorrhagic risk, and accessibility barriers, emphasizing the need for effective adjunctive strategies.

Design/Methods This narrative review synthesizes evidence from randomized controlled trials, observational cohorts, and meta-analyses assessing tirofiban’s pharmacological properties, clinical outcomes, and adverse event profile when used alone or in combination with thrombolysis or endovascular therapy.

Results Tirofiban, a non-peptide glycoprotein IIb/IIIa receptor antagonist, inhibits platelet aggregation and thrombus formation, thereby preventing re-occlusion and recurrent ischemia. Across multiple studies, intravenous tirofiban was associated with lower rates of END, improved 90-day modified Rankin Scale (mRS) scores, and reduced mortality without significantly increasing symptomatic intracranial hemorrhage. Patients with large-artery atherosclerosis derived particular benefit. However, heterogeneity in study design, dosing, and patient selection limits the generalizability of findings.

Conclusions Intravenous tirofiban demonstrates promise as an adjunctive therapy in acute non-cardioembolic stroke, showing potential to improve functional outcomes and reduce mortality with acceptable safety. Despite encouraging evidence, its role remains investigational. Large, multicenter randomized trials are needed to confirm efficacy, establish standardized protocols, and define its optimal integration into acute stroke management.

Authors/Disclosures
Iman Osman Abufatima, MBBS PRESENTER	Dr. Osman Abufatima has nothing to disclose.
Huzaifa S. Nawaz, MBBS	Dr. Nawaz has nothing to disclose.
Rida Eman, MBBS	Ms. Eman has nothing to disclose.
Iqra Yaseen, BDS	Dr. Yaseen has nothing to disclose.
Dr Bushra (People University Of Medical And Health Science, Nawabshah)	No disclosure on file
Maheen Munir Munir, MBBS	Dr. Munir has nothing to disclose.
Mirza Mohammad Ali Baig, MBBS	Dr. Baig has nothing to disclose.
Muhammad Umar	Mr. Umar has nothing to disclose.
Yasar Sattar (Arnot Ogden Cardiology Elmira NY)	No disclosure on file
Hafiz Sohail Ashraf, MD	Dr. Ashraf has nothing to disclose.

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