Bleeding risk of tirofiban, a nonpeptide GPIIb/IIIa platelet receptor antagonist in progressive stroke: An open pilot study

Background. Glycoprotein (gp) IIb/IIIa-receptor antagonists are highly effe ctive antiplatelet agents with proven efficacy in the treatment of acute co ronary and experimental cerebral ischemia. In this study we examined the ra te of hemorrhagic transformation and major bleedings in patients with acute stroke treated with tirofiban, a nonpeptide gpIIb/IIIa antagonist. Methods : Eighteen patients with progressively deteriorating acute ischemic stroke were treated with body-weight adjusted intravenous tirofiban for a mean per iod of 46 h and compared with a matched group of 17 acute ischemic clinical ly stable stroke patients. Cerebral hemorrhage was assessed by cranial imag ing 6-10 days after symptom onset. Results., No major intracranial hemorrha ge was observed in either group. Clinically asymptomatic hemorrhagic infarc tions type I/II/III were detected in 4/2/0 controls and in 4/ 1/1 patients of the tirofiban group, respectively (OR = 0.92; 95% Cl 0.4-2.5). Clinical outcome scores were not different in both groups (p = 0.18). Conclusions:Ti rofiban was not associated with a significantly increased cerebral bleeding rate in acute ischemic stroke. Randomized multicenter studies are needed t o further evaluate the safety and efficacy of tirofiban in the treatment of acute stroke. Copyright (C) 2001 S. Karger AG, Basel.