Safety of Eptifibatide for Subcortical Stroke Progression. Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] Journal article | | Title | Safety of Eptifibatide for Subcortical Stroke Progression. | | Author(s) | Martin-Schild S, Shaltoni H, Abraham AT, Barreto AD, Hallevi H, Gonzales NR, Grotta JC, Savitz SI | | Institution | Department of Neurology, University of Texas-Houston Medical School, Houston, Tex., USA. | | Source | Cerebrovasc Dis 2009 Oct 16; 28(6):595-600. | | Abstract | Background: There is no proven treatment for stroke progression in patients with subcortical infarcts. Eptifibatide, a glycoprotein IIb/IIIa inhibitor, might halt stroke progression by improving flow in the microcirculation.
Methods: We conducted a retrospective analysis of patients with subcortical stroke who experienced deterioration and were treated with eptifibatide (loading dose 180 mug/kg; infusion 2 mug/kg/min) for 24-48 h. Oral antiplatelet agents were started 6 h before discontinuation of eptifibatide.
Results: Twenty-four patients with subcortical strokes were treated. The median admission NIHSS score was 5.0, which worsened to 8.5 (motor 5.0) before starting eptifibatide. The median NIHSS score 24 h after starting eptifibatide was 5.5. At 24 h, 42% had motor NIHSS scores less than or equal to pre-deterioration scores (50% for total NIHSS), and 50% had improved at least 1 motor point compared to pre-eptifibatide scores, which was sustained until hospital discharge. At discharge, the median total NIHSS score was 4.5. Ninety-two percent of patients were discharged home or to inpatient rehabilitation. Treatment was stopped early in 1 case due to a platelet drop <100,000/mul. No systemic or intracerebral bleeding occurred.
Conclusions: Eptifibatide infusion may be safe in patients with subcortical ischemic strokes. Future studies are needed to test the safety and potential efficacy of this agent in subcortical stroke progression. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19844100 |
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