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Dtsch Med Wochenschr. 2004 Mar 19;129(12):607-10.

[Efficacy and safety of treatment of acute ischemic stroke with glycoprotein IIb/IIIa receptor blocker in routine clinical practice].

[Article in German]

Author information

1
Marien-Hospital, Klinik für Innere Medizin I, Kardiologie-Angiologie-Pneumologie, Wesel. klaus.haerten@marien-hospital-wesel.de

Abstract

BACKGROUND:

Platelet aggregation plays an important pathophysiological role in the incidence of myocardial infarction and ischemic stroke. The expression of glycoprotein IIb/IIIa receptors on the surface of activated platelets is the final common pathway of platelet aggregation.

PATIENTS AND METHODS:

Encouraged by the favorable outcome in acute coronary syndromes and by preliminary results, which substantiate the efficacy and safety of GP IIa/III antagonists (GP) in ischemic stroke, we treated 21 cases/20 patients (13 male, 7 female, age 39-79 y.) and conducted a retrospective study using a clinical graduation scale (Modified Rankin Scale MRS). Patients received tirofiban (n = 18) or eptifibatide (n = 3) in the usual cardiological dose 3 h (0.5-8 h) after beginning of symptoms together with "full dose " heparin (n = 8) or "low dose" heparin (n = 12) in the acute phase, with aspirin 100 mg (n = 4), Clopidrogel 75 mg (n = 5), aspirin + clopidogrel (n = 4) in the chronic phase. All patients had a cranial CT, 95% an echocardiography and Doppler sonography of the carotid artery system and some cranial MRI (43%).

RESULTS:

There was no significant clinical deterioration. All except one patient showed a rapid and impressive improvement during the first 24 h after initiation of treatment (median MRS pre/post 3/1).

CONCLUSION:

The results with GP in acute ischemic stroke are promising and further studies should be initiated using especially tirofiban, but with monitoring by cerebral diffusion-weighted MRI before and after treatment.

PMID:
15011129
DOI:
10.1055/s-2004-820569
[Indexed for MEDLINE]
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