Methodology: 4/5
Usefulness: 3/5
Zi W, et al. N Engl J Med. 2023 Jun 1;388(22):2025-2036.
Editorial: Expanding Treatment for Acute Ischemic Stroke beyond Revascularization.
Question and Methods: This multi-centre, triple-blind, double dummy RCT in China aimed to evaluate the functional outcomes and safety of intravenous tirofiban as compared to aspirin in moderate to severe strokes without medium-large vessel occlusion.
Findings: There was a high proportion of excellent functional outcomes by MRS in the tirofiban group (29.1%) compared to the aspirin control group (22.2%). There was no significant mortality difference between the groups.
Limitations: The major limitations included a lack of external validity due to ethnic homogeneity of the participants and selection for a specific stroke type, as well as a lack of control for outpatient therapies received by participants.
Interpretation: Tirofiban appears to be an effective and generally safe acute stroke therapy for patients in this Chinese study; however, this effect needs to be studied in a more diverse population to assess its impact on our practice.
JC Supervisor: Dr. Vaillancourt
