Original Investigation

Intravenous Tirofiban After Tenecteplase in Acute Ischemic Stroke

JAMA 10.1001/jama.2026.5245

May 08, 2026 at 6:05 AM EDT

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Among patients with acute ischemic stroke without large or medium vessel occlusion or cardioembolic source, does intravenous tirofiban after an insufficient response to intravenous tenecteplase improve functional outcomes?In this randomized trial of 359 patients, tirofiban significantly increased the proportion of patients with an excellent outcome (defined as a score of 0 or 1 on the modified Rankin Scale) at 90 days compared with placebo (63.8% vs 52.2%, respectively).These findings suggest a potential benefit of adjunctive intravenous tirofiban after intravenous tenecteplase in this specific patient population and warrant further investigation.

Corresponding Authors: Guoyong Zeng, MD, Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University (Ganzhou People’s Hospital), No. 16 Meiguan Rd, Zhanggong District, Ganzhou 341000, China (hsyygy@163.com); Zhongming Qiu, MD, Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yan Jiang Xi Rd, Guangzhou 510120, China (qiuzhongmingdoctor@163.com).

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