Objective:

To evaluate the clinical efficacy and bleeding risk of tirofiban combined with intravenous alteplase in patients with acute ischaemic stroke (AIS).

Approach:

• Study Design: Retrospective study of 90 AIS patients divided into a combined group (CG, n = 45; tirofiban plus alteplase) and an alteplase group (AG, n = 45; alteplase alone).
• Outcomes Measured: Primary outcome was the 90-day modified Rankin Scale; secondary outcomes included neurological deficits, coagulation parameters, inflammatory biomarkers, vascular status, daily living activities, and bleeding events.

Key Findings:

• CG had significantly lower NIHSS scores at 24 h, 7 days, and 14 days compared to AG (p < 0.01).
• Post-treatment PT, APTT, and D-dimer were higher in CG, while fibrinogen was lower (all p < 0.001).
• At day 7, hs-CRP, IL-6, and TNF-α were significantly lower in CG (all p < 0.001).
• CG had a higher rate of favorable post-treatment vascular status (p = 0.030) and higher 90-day outcomes (mRS ≤ 2) (p = 0.020).
• Total bleeding rate was 28.89% in CG and 17.78% in AG, with no significant difference (p = 0.214).

Interpretation:

Limitations:

• Retrospective design limits causal inferences.
• Small sample size may affect generalizability.
• Non-randomized treatment assignment could introduce bias.

Conclusion: