Effects of Oral Antiplatelet Agents and Tirofiban on Functional Outcomes of Patients with Non-Disabling Minor Acute Ischemic Stroke

Wang, Huan; Li, Xiaoshu; Liu, Chengchun; Huang, Shuhan; Liang, Chun-Rong; Zhang, Meng

doi:10.1016/j.jstrokecerebrovasdis.2020.104829

Cited by 10 publications

(5 citation statements)

References 23 publications

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“…The role of antiplatelet drugs is to prevent platelet activation either by inhibiting the platelet activation pathways or by stimulating inhibitory pathways [ 6 ]. These include cyclooxygenase (COX) blockers, as well as adenosine diphosphate (ADP) receptor antagonists and glycoprotein IIb/IIIa (GPIIb/IIIa) receptor antagonists [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Flavonoids: Antiplatelet Effect as Inhibitors of COX-1

et al. 2022

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Flavonoids are compounds with a benzopyranic structure that exhibits multiple pharmacological activities. They are known for their venotonic activity, but their mechanism of action remains unclear. It is thought that, as this mechanism is mediated by prostaglandins, these compounds may interfere with the arachidonic acid (AA) cascade. These assays are designed to measure the antiplatelet aggregation capacity of quercetin, rutin, diosmetin, diosmin, and hidrosmin, as well as to evaluate a potential structure−activity ratio. In this paper, several studies on platelet aggregation at different concentrations (from 0.33 mM to 1.5 mM) of different flavone compounds are conducted, measuring platelet aggregation by impedance aggregometry, and the cyclooxygenase (COX) activity by metabolites generated, including the activity of the pure recombinant enzyme in the presence of these polyphenols. The results obtained showed that quercetin and diosmetin aglycones have a greater antiplatelet effect and inhibit the COX enzyme activity to a greater extent than their heterosides; however, the fact that greater inhibition of the pure recombinant enzyme was achieved by heterosides suggests that these compounds may have difficulty in crossing biological membranes. In any case, in view of the results obtained, it can be concluded that flavonoids could be useful as coadjuvants in the treatment of cardiovascular pathologies.

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Section: Introductionmentioning

confidence: 99%

Flavonoids: Antiplatelet Effect as Inhibitors of COX-1

et al. 2022

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“…Owing to these merits, the antiplatelet aggregation effect of tiro ban is relatively stronger and faster than that of traditional antiplatelet drugs, such as aspirin or clopidogrel. This hypothesis is supported by recent studies that have used methods involving propensity score matching (PSM) to evaluate the potential imbalances associated with the safety and e cacy of conventional antiplatelet agents and those of tiro ban 17 .…”

Section: Discussionmentioning

confidence: 89%

Early intravenous administration of tirofiban is recommended in patients with acute ischemic stroke treated with alteplase: a meta-analysis

Huo

Yang

Zhou

et al. 2023

Preprint

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Background: The occurrence of early neurological deterioration (END) following intravenous thrombolysis (IVT) is considered a particularly ominous clinical event and is strongly correlated with poor outcomes. Initiating tirofiban within 24 h after IVT has been suggested as a better treatment option to achieve long-term functional outcomes. However, the rationality of this remedy is a controversial. The purpose of the study was to evaluate the safety and efficacy of early intravenous tirofiban administration after IVT in patients with acute ischemic stroke (AIS). Methods: Databases including PubMed, EMBASE, Cochrane Library, and Web of Science were searched for clinical trials on early tirofiban implementation after IVT in patients with AIS from inception to September 2022. Odds ratios (ORs) were generated for dichotomous variants via meta-analysis using STATA 17.0 MP. Results: Five clinical trials with 725 patients were eligible. The study outcomes demonstrated that early tirofiban administration after IVT was not associated with symptomatic intracranial hemorrhage (Odds ratios [OR], 0.78; 95%confidence interval [CI], 0.22 - 2.74; P=0.70), asymptomatic intracranial hemorrhage (OR, 1.11; 95%CI, 0.52 - 2.37; P=0.80), systemic bleeding (OR, 0.97; 95%CI, 0.42 - 2.23; P=0.94), and death (OR, 1.05; 95%CI, 0.47 - 2.31; P=0.91), but may reduce the incidence of END (OR, 0.09; 95% CI, 0.02 - 0.50; P=0.01), and was significantly associated with 90-day excellent (modified Rankin scale[mRS] score 0–1) (OR, 2.01; 95% CI, 1.35 - 3.02; P=0.00) and favorable (mRS score 0–2) (OR, 2.30; 95% CI, 1.63 - 3.23; P=0.00) functional outcomes. Conclusion: The early intravenous administration of tirofiban after IVT in patients with AIS may be a safe and effective treatment strategy that improves long-term neurological functional outcomes without increasing the risk of adverse events.

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“…Intravenous thrombolysis is an effective measure for acute ischemia cerebral vessel diseases, which enables blocking cerebral arteries to recover quickly and the blood supply in the brain to be supplemented. In clinical, thrombolysis therapy reduces the enzymatic activity of fibrinolysis in the human body and raises the activity of thrombin to prevent the occurrence of new thrombus [5][6][7][8] . In the study, after treatment, the blood platelet-related parameters in the research group is superior to the control group (P < 0.05); after treatment, the Barthel index in the research group is superior to the control group (P < 0.05); the effective rate in the research group is higher than the control group (P < 0.05).…”

Section: Discussionmentioning

confidence: 99%

The Effect of the Early Application of Tirofiban on Acute Ischemic Stroke (AIS) after Intravenous Thrombolysis with Urokinase

2023

JCNR

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Objective: Discussion and analysis of the effect of the early application of Tirofiban on acute ischemic stroke (AIS) after intravenous thrombolysis with urokinase. Method: The subjects of this study are 40 patients with AIS admitted at the Yibin Fourth People’s Hospital, of which were computer-randomized into a control group (20 cases, with regular urokinase intravenous thrombolysis therapy) and a research group (20 cases, combined with early Tirofiban treatment) from January 2018 to December 2022. The intervention outcomes between these two groups were compared and analyzed. Result: The blood platelet-related parameters before treatment had no statistical difference between the two groups (P > 0.05), but the research group was higher than that of the control group after treatment (P < 0.05). The Barthel index before treatment in both groups had no statistical difference (P > 0.05), but the research group was higher than that of the control group after treatment (P < 0.05). Conclusion: Early Tirofiban treatment for patients with AIS after intravenous thrombolysis with urokinase could effectively regulate the blood platelet-related parameters, hence improving treatment benefits and living capacity for patients, with definite clinical benefits.

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Effects of Oral Antiplatelet Agents and Tirofiban on Functional Outcomes of Patients with Non-Disabling Minor Acute Ischemic Stroke

Cited by 10 publications

References 23 publications

Flavonoids: Antiplatelet Effect as Inhibitors of COX-1

Flavonoids: Antiplatelet Effect as Inhibitors of COX-1

Early intravenous administration of tirofiban is recommended in patients with acute ischemic stroke treated with alteplase: a meta-analysis

The Effect of the Early Application of Tirofiban on Acute Ischemic Stroke (AIS) after Intravenous Thrombolysis with Urokinase

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