The effect of remote ischemic conditioning combined with tirofiban on early neurological deterioration in small artery occlusive stroke.

Authors

Zhiyong Zhang, Xinxiu Liu, Lei Wang, Xunming Ji

Published in

BMC neurology. Volume 25. Issue 1. Pages 434. Oct 17, 2025. Epub Oct 17, 2025.

Abstract

Early neurological deterioration (END) remains a significant challenge in the treatment of small artery occlusive (SAO) stroke. The purpose of this study was to evaluate the efficacy and safety of remote ischemic conditioning (RIC) combined with tirofiban for patients with SAO stroke experiencing END.
We retrospectively reviewed 143 consecutive patients with acute SAO stroke experiencing END who received intravenous tirofiban between January 2021 and December 2024. According to the use of RIC treatment, the patients were divided into RIC group (72 cases) and control (no-RIC) group (71 cases). The primary efficacy outcome was early neurological improvement (a decrease of ≥2 points in the National Institutes of Health Stroke Scale (NIHSS) score at 7 days after END). The secondary efficacy outcomes included absolute reduction in NIHSS score at 7 days, modified Rankin Scale scores at 90 days, proportion of disabling stroke, recurrence of ischemic stroke within 90 days. The safety outcomes were symptomatic intracranial hemorrhage, any ICH, adverse events, and 90-day all-cause mortality.
The RIC group exhibited a greater absolute reduction in NIHSS score at 7 days after treatment (mean ± SD: 1.67 ± 1.80 vs. 0.96 ± 1.91; adjusted P=0.015), and early neurological improvement was achieved in 55.6% of the RIC group and 29.6% of the control group (adjusted odds ratio, 3.34 [95% CI, 1.61-6.93]; P=0.001). No symptomatic intracranial hemorrhage or any intracranial hemorrhage occurred in either group. Additionally, the 90-day all-cause mortality did not differ significantly between the RIC and sham groups (1.4% vs. 2.8%, hazard ratio, 0.49 [95% CI, 0.04-5.41]; P=0.561).
In patients with small artery occlusive stroke experiencing END, the combination of RIC and tirofiban seems associated with early neurological improvement without increasing the risk of intracranial hemorrhage or serious adverse events. Future multicenter, large-sample randomized clinical trials are warranted to validate these results.

PMID:
41107783
Bibliographic data and abstract were imported from PubMed on 18 Oct 2025.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.