{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T23:17:32Z","timestamp":1790464652102,"version":"4.1.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,21]]},"abstract":"\n Background<\/jats:title>\n Tirofiban has emerged as a potential treatment for acute ischemic stroke. We aimed to evaluate the efficacy and safety of tirofiban in patients with minor stroke within 4.5 hours of symptom onset.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We emulated a target trial using observational data. Patients with minor stroke (National Institutes of Health Stroke Scale score \u22645) who received tirofiban or alteplase within 4.5 hours were included. The primary outcome was excellent functional outcome (modified Rankin Scale score 0\u20131) at 90\u2009days. Secondary outcomes included modified Rankin Scale score of 0 to 2 at 90\u2009days, 24\u2010hour National Institutes of Health Stroke Scale changes, ordinal shift in modified Rankin Scale, and early neurological deterioration or improvement. Safety outcomes included symptomatic intracranial hemorrhage, intracranial hemorrhage, any bleeding, and 90\u2010day all\u2010cause death.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 677 eligible patients, 369 received tirofiban and 308 received alteplase. There was no significant difference in 90\u2010day modified Rankin Scale score of 0 to 1 between groups (risk ratio, 1.06 [95% CI, 0.97\u20131.16];\n P<\/jats:italic>\n =0.20). Tirofiban was associated with lower risks of neurological deterioration at 24 hours (risk ratio, 0.31 [95% CI, 0.16\u20130.59];\n P<\/jats:italic>\n <0.001), intracranial hemorrhage (risk ratio, 0.06 [95% CI, 0.01\u20130.46];\n P<\/jats:italic>\n =0.007), and any bleeding (risk ratio, 0.13 [95% CI, 0.06\u20130.30];\n P<\/jats:italic>\n <0.001). No symptomatic intracranial hemorrhage occurred in the tirofiban group. Ninety\u2010day all\u2010cause death did not differ significantly.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In minor acute ischemic stroke treated within 4.5 hours, intravenous tirofiban showed no significant difference in 90\u2010day functional outcomes relative to alteplase and was associated with lower risks of early neurological deterioration and bleeding, suggesting it could be considered a potential treatment option pending further randomized trials.<\/jats:p>\n <\/jats:sec>\n \n Registration<\/jats:title>\n \n URL:\n https:\/\/www.chictr.org.cn<\/jats:ext-link>\n ; Unique Identifier: ChiCTR2500106107.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.125.047187","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T03:26:01Z","timestamp":1783740361000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Tirofiban Versus Alteplase for Patients With Minor Acute Ischemic Stroke: A Target Trial Emulation Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7646-2277","authenticated-orcid":false,"given":"Chengbing","family":"Wang","sequence":"first","affiliation":[{"name":"China\u2013Japan Union Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[{"name":"China\u2013Japan Union Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Li","sequence":"additional","affiliation":[{"name":"China\u2013Japan Union Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenglin","family":"Chen","sequence":"additional","affiliation":[{"name":"China\u2013Japan Union Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3154-9218","authenticated-orcid":false,"given":"Jing","family":"Mang","sequence":"additional","affiliation":[{"name":"China\u2013Japan Union Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8995-9706","authenticated-orcid":false,"given":"Zhongxin","family":"Xu","sequence":"additional","affiliation":[{"name":"China\u2013Japan Union Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00038-3"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.031329"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030898"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.011528"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000211"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2396987321989865"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/svn-2020-000378"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.8496"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.7827"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000213863"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-019-01078-0"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.12584"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2214299"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2024.0868"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.16.1265"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.016735"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2024.4688"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2393"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwv254"}],"container-title":["Journal of the American Heart 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