Abstract WP25: Eptifibatide in Acute Ischemic Strokes Without Large Vessel Occlusions

Abstract

Background: Platelet glycoprotein IIb/IIIa inhibitors are currently being researched for patients with acute ischemic stroke (AIS), however there is no consensus on which inhibitor or dose is both safe and effective. Tirofiban has recently been studied, however it was associated with an increased risk of intracranial bleeding. In this study we share our experience using eptifibatide given it has shown to be as effective as tirofiban with a better safety profile. Methods: In this multi-center retrospective analysis, we screened 102 patients who received an eptifibatide bolus of 135 mcg/kg followed by 0.5 mcg/kg/min infusion and 332 patients treated with usual stroke care between December 2022 and May 2023. Patients were excluded if the NIHSS on presentation but within 24 hours of last known well was less than 3 or if the patient had a large vessel occlusion (LVO). There were 7 and 31 patients included in the eptifibatide and usual care group respectively. Our primary endpoint was change in NIHSS from admission to discharge. Our safety endpoints were symptomatic ICH and any ICH. Results: No patients included in the study experienced a symptomatic ICH. The median time of eptifibatide infusion was 24 hours with some patients receiving the infusion for multiple days. Conclusion: While larger studies are needed to confirm our findings, eptifibatide may be safe and effective in the treatment of AIS without LVO.