Globally, stroke remains a leading cause of mortality and long-term disability. It’s a race against time, where every second is crucial for saving brain tissue. Although thrombolytic therapy has saved many lives, complete recovery of the patient’s health is often not achieved. Therefore, the medical community is constantly working on finding methods that will help patients return to a fulfilling life after a stroke.
Against the backdrop of this search, new, groundbreaking research has shown that the early infusion of tirofiban (an anti-clotting drug) after standard thrombolytic treatment significantly improves the condition of certain stroke patients. This is promising for millions of people with acute ischemic stroke and could potentially change the disease management strategies.
In acute ischemic stroke, the blockage of a blood vessel by a thrombus causes the interruption of blood supply, oxygen deficiency, and, consequently, the death of nerve tissue. The current standard treatment includes intravenous thrombolysis, which is used to dissolve the clot within 4.5 hours of symptom onset.
The ASSET-IT Study:
Chinese researchers conducted the ASSET-IT clinical trial, which involved 832 patients with non-cardioembolic acute ischemic stroke. After receiving the standard clot-dissolving drug, patients were randomly assigned to receive either tirofiban or a placebo within one hour of starting treatment. Tirofiban suppresses platelet aggregation, thereby reducing the risk of re-occlusion of the artery after the initial therapy.
After 90 days, approximately 66% of patients treated with tirofiban achieved complete/near-complete recovery, compared to 55% in the placebo group. Functional independence also improved in the tirofiban group, meaning more patients could take care of themselves and perform daily activities independently.
Of course, the potential downside must be considered: a slight increase in the probability of severe intracerebral hemorrhage was noted. This occurred in about 1.7% of patients treated with tirofiban, while no such complication was recorded in the placebo group.
The rapid and stable restoration of blood flow is critically important for recovery during a stroke. While thrombolytic drugs clear the blood vessel, early platelet aggregation can reduce their full effect. Tirofiban, with its rapid action, prevents platelet clumping, thereby ensuring long-term patency of the artery. This research may lead to changes in standard protocols in the future.
Source: NEJM
