Objective:

To evaluate the efficacy of adjunctive intravenous tirofiban in patients with acute ischemic stroke who had an inadequate early clinical response to intravenous tenecteplase, specifically focusing on those with NIHSS scores of 4 or higher.

Key Findings:

• Functional independence (mRS 0-2) occurred in 79% of tirofiban patients vs. 72% in placebo, but this difference was not statistically significant.

Interpretation:

Tirofiban may improve functional outcomes in patients with inadequate response to tenecteplase, but results from adjusted analyses were not statistically significant, warranting caution in interpretation.

Limitations:

• All participants were Chinese, which may limit applicability to other populations, particularly given known differences in intracranial atherosclerosis burden.

Conclusion:

Early intravenous tirofiban may be a potential adjunctive treatment following tenecteplase in select patients with limited clinical response, but generalizability of the findings should be approached with caution.