Trial reportEuropean stroke journal2026
Effect of Admission Diabetes History on Safety and Efficacy of Early Tirofiban Infusion after Intravenous Thrombolysis in Ischaemic Stroke: a post-hoc analysis of the ASSET-IT trial.
Trial report in European stroke journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThis study aimed to investigate how diabetes mellitus (DM) influences the efficacy of early tirofiban administration after intravenous thrombolysis in patients with acute ischaemic noncardioembolic stroke. PATIENTS AND
methodsThis was a post-hoc analysis of the ASSET-IT (Advancing Stroke Safety and Efficacy through Early Tirofiban Administration after Intravenous Thrombolysis) trial. Patients were categorised into DM and non-DM groups based on baseline diabetes history. The primary efficacy outcome was an excellent functional outcome at 90 days, defined as an mRS score of 0-1. Safety outcomes included sICH within 36 h, any ICH and all-cause mortality within 90 days. The effect of diabetes on treatment outcomes was assessed using multivariable regression models adjusting for relevant confounders.
resultsA total of 832 patients at 38 centres were randomised in the ASSET-IT trial (414 to tirofiban, 418 to placebo). The median age was 69 years (IQR, 59-76); 301 (36.2%) were women. Overall, 191 patients (23.0%) had diabetes mellitus. Among patients without diabetes, an excellent functional outcome at 90 days occurred in 69.0% of patients in the tirofiban group and 55.8% in the placebo group, whereas among patients with diabetes, the corresponding rates were 55.0% and 52.0%, respectively. The nominal P value for the treatment-by-diabetes interaction was .009. The 90-day mortality was higher in the DM group receiving tirofiban (6.6% vs 2.0%; RR, 3.79; 95% CI, 0.84-17.05; P = .082) but not in the non-DM group (3.4% vs 4.4%; RR, 0.82; 95% CI, 0.40-1.70; P = .597).
conclusionExploratory post-hoc findings from the ASSET-IT trial suggest that the association between early tirofiban administration after intravenous thrombolysis and 90-day functional outcomes may differ according to diabetes status. These hypothesis-generating observations require confirmation in prospective studies with pre-specified subgroup analyses.
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