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.

By: Dr. Maria Berliant

JC Supervisor: Dr. Vaillancourt




  • Maria Berliant

    Dr. Maria Berliant is an FRCPC Emergency Medicine resident at the University of Ottawa

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  • Hans Rosenberg

    Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.

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  • Christian Vaillancourt

    Senior Scientist, Clinical Epidemiology Program Ottawa Hospital Research Institute Full Professor, Emergency Medicine University of Ottawa Research Chair in Emergency Cardiac Resuscitation, Emergency Medicine University of Ottawa Associate Medical Director, Regional Paramedic Program for Eastern Ontario Research Interests: Dr. Vaillancourt's current research program focuses on pre-hospital care, specifically improving care and survival for cardiac arrest and trauma victims.

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