Evidence map›Paper›PMID 40576038›Full record

ArticleJournal of the American Heart Association2025

Effect of Intravenous Tirofiban Versus Placebo on Excellent Outcome in Patients With Acute Ischemic Stroke: The Multicenter, Randomized INSTANT Trial Protocol.

Fan Zhang, Minghui Xiao, Cong Zhang, Guangxiong Yuan, Zhiyong Xie, Yi Yin, Ruize Zhou, Shanggui Yuan, Genxiang Xiao, Donghuan Mei and 17 more

Abstract readClinical Trial Protocol
In one paragraph

Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Third Year in Review, Fourth Year in Preview, and the 2025Journal of the American Heart Association · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Fan ZhangGanzhou People's Hospital Ganzhou China.ORCID 0000-0002-4569-1891
Minghui XiaoPeople's Hospital of Wan'an City Wan'an China.
Cong ZhangGanzhou People's Hospital Ganzhou China.ORCID 0009-0000-3441-7304
Guangxiong YuanXiangtan Central Hospital Xiangtan China.ORCID 0009-0001-1813-5005
Zhiyong XiePeople's Hospital of Yudu City Yudu China.
Yi YinPeople's Hospital of Shangyou City Shangyou China.
Ruize ZhouPeople's Hospital of RuiJin City RuiJin China.
Shanggui YuanSecond Hospital of Xingguo City Xingguo China.
Genxiang XiaoPeople's Hospital of ShiCheng City ShiCheng China.
Donghuan MeiPeople's Hospital of County Xunwu Xunwu China.ORCID 0009-0009-4729-4441
Xiaobing ZengPeople's Hospital of Anyuan City Anyuan China.
Huashi LiuPeople's Hospital of Dayu City Dayu China.
Huadong LiPeople's Hospital of Chongyi City Chongyi China.
Hongwen LiuGanzhou Municipal Hospital Ganzhou China.
Jinchang TanTraditional Chinese Medicine Hospital of Yudu City Yudu China.
Bin ChenPeople's Hospital of Quannan City Quannan China.
Qingqing FuGanzhou People's Hospital Ganzhou China.ORCID 0000-0002-1489-8865
Bin LiGanzhou People's Hospital Ganzhou China.ORCID 0009-0008-9486-7591
Jinxing LaiGanzhou People's Hospital Ganzhou China.ORCID 0009-0007-5271-1268
Wei SunGanzhou People's Hospital Ganzhou China.ORCID 0009-0009-5495-2924
Shuhua XieGanzhou People's Hospital Ganzhou China.ORCID 0009-0002-8500-2023
Zhaohui LaiGanzhou People's Hospital Ganzhou China.ORCID 0000-0002-1170-4658
Zhongming QiuThe 903rd Hospital of the People's Liberation Army Hangzhou China.ORCID 0000-0002-1622-9526
Zidian JiangZhongmeng Hospital of Hexigten Banner Chifeng City Hexigten Banner China.ORCID 0009-0000-0114-4442
Xianghong LiuGanzhou People's Hospital Ganzhou China.ORCID 0000-0002-8136-3713
Guoyong ZengGanzhou People's Hospital Ganzhou China.ORCID 0000-0002-3179-5251
INSTANT investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is common that symptoms do not improve or even worsen after intravenous thrombolysis (IVT) in acute ischemic stroke. However, it remains unknown whether early administration of tirofiban after IVT may improve clinical outcomes. This trial aims to assess the efficacy and safety of early administration of tirofiban after IVT with tenecteplase in acute ischemic stroke during the 90-day follow-up period after treatment.

methodsThe INSTANT (Intravenous Tenecteplase and Tirofiban for Acute Ischemic Stroke) trial is an investigator-initiated, randomized, placebo-controlled, double-blind, multicenter trial. In the study, 310 patients with acute nonlarge/medium-sized vascular occlusion and nonatrial fibrillation stroke who are treated with intravenous tenecteplase will be consecutively randomized to intravenous tirofiban or placebo in a 1:1 ratio over 2 years across 50 intravenous thrombolysis-capable stroke centers in China. In addition, eligible subjects will receive best medical treatment according to national guidelines. The primary efficacy end point is excellent functional status, defined as a score of 0 or 1 on the modified Rankin Scale at 90 days after randomization. Safety outcomes include symptomatic intracranial hemorrhage within 48 hours and mortality at 90 days.

conclusionsThe INSTANT trial was designed to determine the role of tirofiban within 24 hours after IVT in patients with acute ischemic stroke. Our primary objective is to investigate whether the early administration of tirofiban following IVT can enhance the proportion of patients exhibiting no or minimal symptoms post acute ischemic stroke. REGISTRATION: URL: ChiCTR2300074368; Unique Identifier: www.chictr.org.cn.

Indexed as

Fibrinolytic AgentsIschemic StrokePlatelet Aggregation InhibitorsTenecteplaseThrombolytic TherapyTirofibanAdministration, IntravenousAgedChinaDouble-Blind MethodFemaleHumansMaleMiddle AgedMulticenter Studies as TopicRandomized Controlled Trials as TopicFibrinolytic AgentsPlatelet Aggregation InhibitorsTenecteplaseTirofibanacute ischemic strokeexcellent outcomeintravenous thrombolysisprotocolrandomized trialtenecteplasetirofiban

Identifiers

PMID40576038
PMCPMC12449896

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.