Published online before print June 26, 2003, doi: 10.1161/01.STR.0000080535.61188.A6
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2003;34:1932.)
© 2003 American Heart Association, Inc.
Original Contributions |
Thrombolysis With Recombinant Tissue Plasminogen Activator and Tirofiban in Stroke
Preliminary Observations
From the Departments of Neurology, Heinrich-Heine University Düsseldorf, Düsseldorf (R.J.S., M.H., U.J., M.S.), and Karl-Rupprecht Universität Heidelberg, Heidelberg (P.A.R., C.S.), Germany.
Correspondence to Dr Rüdiger J. Seitz, Department of Neurology, University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany. E-mail seitz{at}neurologie.uni-duesseldorf.de
Background and Purpose— We sought to investigate the feasibility of the combined use of low-dose recombinant tissue plasminogen activator (rtPA) and tirofiban, a glycoprotein IIb/IIIa (GPIIb/IIIa) receptor antagonist, for systemic thrombolysis in acute stroke.
Methods— Consecutive patients who were treated with systemic application of low-dose rtPA and body weight–adjusted tirofiban (rtPA+T group; n=37) were evaluated retrospectively during 1999–2001. Patients in the rtPA+T group were compared with a group of patients treated with a dose of 0.9 mg/kg body weight in a different center (rtPA group; n=119). The 41 patients with infarctions of the middle cerebral artery territory who were not eligible for thrombolytic treatment because of medical contraindications or arrival in the hospital >3 hours after stroke onset served as controls. For matched comparisons, the National Institutes of Health Stroke Scale on admission and the Rankin Scale on discharge 5 days after stroke were used.
Results— The patients treated with rtPA+T or rtPA improved (P<0.05) compared with the controls at discharge; patients in the rtPA+T and rtPA groups reached a Rankin Scale score of 0 to 2 in 63% and 55%, respectively, while only 16% of the controls achieved this score. Death rates (8% in rtPA+T group and 5% in rtPA group) were similar among the 2 treatment groups. They included 1 fatal hemorrhage in the rtPA+T group and 4 fatal hemorrhages in the rtPA group. Five percent of the untreated patients developed symptomatic, nonfatal cerebral hemorrhage.
Conclusions— Systemic combined thrombolysis with rtPA+T seems to be a feasible treatment in acute stroke.
Key Words: platelet glycoprotein GPIIb-IIIa complex • platelets • stroke • thrombolysis
This article has been cited by other articles:
 |
|
 |
|
  R. J. Seitz, S. Meisel, P. Weller, U. Junghans, H.-J. Wittsack, and M. Siebler Initial Ischemic Event: Perfusion-weighted MR Imaging and Apparent Diffusion Coefficient for Stroke Evolution Radiology, December 1, 2005; 237(3): 1020 - 1028. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Mangiafico, M. Cellerini, P. Nencini, G. Gensini, and D. Inzitari Intravenous Glycoprotein IIb/IIIa Inhibitor (Tirofiban) followed by Intra-Arterial Urokinase and Mechanical Thrombolysis in Stroke AJNR Am. J. Neuroradiol., November 1, 2005; 26(10): 2595 - 2601. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Seitz, S. Meisel, M. Moll, H. -J. Wittsack, U. Junghans, and M. Siebler The effect of combined thrombolysis with rtPA and tirofiban on ischemic brain lesions Neurology, June 8, 2004; 62(11): 2110 - 2112. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Straub, U. Junghans, V. Jovanovic, H. J. Wittsack, R. J. Seitz, and M. Siebler Systemic Thrombolysis With Recombinant Tissue Plasminogen Activator and Tirofiban in Acute Middle Cerebral Artery Occlusion Stroke, March 1, 2004; 35(3): 705 - 709. [Abstract] [Full Text] [PDF]
|
|