Subgroup analysis of tirofiban's effect on early neurological deterioration in AIS-LVO patients undergoing endovascular treatment

Abstract

Abstract Purpose This study aimed to investigate whether stroke subtype influences the association between tirofiban use and END risk in AIS-LVO patients undergoing endovascular treatment (EVT) . Methods This was a retrospective cohort study of 813 consecutive AIS-LVO patients treated with EVT. Subgroup analysis was conducted based on lesion location, TOAST classification and onset time. Univariate and multivariate logistic regression models were used to explore the association between tirofiban use and END risk in stroke subtype. Results This study included 110 patients with END and 703 patients without END. Based on subgroup analysis of lesion location, TOAST aetiology classification and onset time, the results showed that postoperative use of tirofiban was an independent protective factor for END in the anterior circulation (OR, 0.486; 95% CI 0.282–0.837; p = 0.009), LAA type (OR, 0.369; 95% CI 0.195–0.699; p = 0.002) and onset time more than 6 hours (OR, 0.388; 95% CI 0.212–0.710; p = 0.002). Conclusion The influencing factors for END vary significantly across patients with different lesion locations, TOAST classifications and onset times. Notably, Postoperative use of intravenous tirofiban may improve END in patients with anterior circulation, LAA type and an onset time of more than 6 hours.