Background: Even undergoing mechanical thrombectomy (MT), patients with acute vertebrobasilar artery occlusion (AVBAO) still have a high rate of mortality. Tirofiban is a novel antiplatelet agent which is now widely empirically used in acute ischemic stroke (AIS). In this study, we aimed to evaluate the safety and efficacy of tirofiban as adjunctive therapy for MT in AVBAO.
Methods: From October 2016 to July 2021, consecutive AVBAO patients receiving MT were included in the prospective stroke registry. The short-term outcomes were (1) symptomatic intracerebral hemorrhage (sICH); (2) in-hospital death; (3) National Institute of Health Stroke Scale (NIHSS) at discharge. The Long-term outcomes were: (1) modified Rankin Scale (mRS) at 3 months; (2) death at 3 months.
Results: A total of 130 eligible patients were included in the study, 64 (49.2%) patients received tirofiban. In multivariate regression analysis, no significant differences were observed in all outcomes between the tirofiban and non-tirofiban group [sICH (adjusted OR 0.96; 95% CI, 0.12-7.82, p = 0.97), in-hospital death (adjusted OR 0.57; 95% CI, 0.17-1.89, p = 0.36), NIHSS at discharge (95% CI, -2.14-8.63, p = 0.24), mRS (adjusted OR 1.20; 95% CI, 0.40-3.62, p = 0.75), and death at 3 months (adjusted OR 0.83; 95% CI, 0.24-2.90, p = 0.77)].
Conclusions: In AVBAO, tirofiban adjunctive to MT was not associated with an increased risk of sICH. Short-term (in-hospital death, NIHSS at discharge) and long-term outcomes (mRS and death at 3 months) seem not to be influenced by tirofiban use.
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http://dx.doi.org/10.1186/s12883-022-02996-5 | DOI Listing |
Health Secur
January 2025
Ricardo Rohweder, MSc, is a PhD Student, Programa de Pós-Graduação em Genética e Biologia Molecular; Lavinia Schuler-Faccini, PhD, is a Professor, Department of Genética and Programa de Pós-Graduação em Genética e Biologia Molecular; and Gonçalo Ferraz, PhD, is a Professor, Programa de Pós-Graduação em Ecologia and Programa de Pós-Graduação em Genética e Biologia Molecular; all at the Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Lavinia Schuler-Faccini is also a Professor, Medical Genetics Service of Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
In early 2020, to halt the spread of SARS-CoV-2, the state government of Rio Grande do Sul in Brazil established a public health assessment and response framework known as a "controlled distancing model." Using this framework, the government divided the state into 21 regions and evaluated them against a composite index of disease transmission and health service capacity. Regions were assessed using a color-coded scale of flags that was updated on a weekly basis and used to guide the adoption of nonpharmaceutical interventions.
View Article and Find Full Text PDFJAMA
January 2025
Department of Emergency Medicine, Henry Ford Health, Detroit, Michigan.
Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.
Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.
Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.
JAMA Netw Open
January 2025
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Importance: Lung cancer in individuals who have never smoked (INS) is a growing global concern, with a rapidly increasing incidence and proportion among all lung cancer cases. Particularly in East Asia, opportunistic lung cancer screening (LCS) programs targeting INS have gained popularity. However, the sex-specific outcomes and drawbacks of screening INS remain unexplored, with data predominantly focused on women.
View Article and Find Full Text PDFAm J Cardiovasc Drugs
January 2025
Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China.
Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies (mAbs) have demonstrated promising effects in lowering cardiovascular incidents among patients with acute coronary syndrome. However, their influence on early platelet reactivity after primary percutaneous coronary intervention (PPCI) remains unclear.
Objectives: This research sought to investigate the effects of entirely human anti-PCSK9 antibodies on platelet function as measured by thrombelastography and 12-month postoperative results in patients receiving PPCI and treated with ticagrelor-based dual antiplatelet therapy.
Discov Oncol
January 2025
Western Institute of Digital-Intelligent Medicine, 401329, Chongqing, China.
Background: The metabolism of stearoyl-GPE plays a key role in the liver metastasis of gastric cancer. This investigation delves into the mechanisms underlying the intricate tumor microenvironment (TME) heterogeneity triggered by stearoyl metabolism in gastric cancer with liver metastasis (LMGC), offering novel perspectives for LMGC.
Objective: Utilizing Mendelian randomization, we determined that stearoyl metabolism significantly contributes to the progression of gastric cancer (GC).
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