ATTRACTION
(2026)Objective
Prospective double-blind RCT testing whether adjunctive tirofiban after successful EVT (mTICI 2b-3) increases 90-day functional independence in anterior LVO stroke.
Study Summary
ā¢ Primary 90-day mRS 0-2: 49.3% vs 43.3%, aRR 1.15 (1.03-1.27).
ā¢ 90d mRS shift: cOR 1.22 (1.01-1.48).
ā¢ sICH 11.9% vs 19.4% (NS); mortality 18.3% vs 19.0% (NS).
ā¢ Tirofiban increased functional independence without increasing sICH.
ā¢ 90d mRS shift: cOR 1.22 (1.01-1.48).
ā¢ sICH 11.9% vs 19.4% (NS); mortality 18.3% vs 19.0% (NS).
ā¢ Tirofiban increased functional independence without increasing sICH.
Intervention
Tirofiban 5 ug/kg IA bolus (max 5 mg) + 0.1 ug/kg/min IV infusion up to 24 h vs IA + IV placebo
Inclusion Criteria
China. ICA-IC/M1/M2 occlusion; ASPECTS >=6 on NCCT or DWI; NIHSS 6-30; achieved mTICI 2b-3 after EVT; onset to randomization within 24 h.
Study Design
Arms: Tirofiban vs placebo (same regimen)
Patients per Arm: Tirofiban n=689 vs Placebo n=691 (total 1380)
Outcome
ā¢ Primary 90-day mRS 0-2: 49.3% vs 43.3%, aRR 1.15 (1.03-1.27).
ā¢ 90d mRS shift: cOR 1.22 (1.01-1.48).
ā¢ sICH: 11.9% vs 19.4% (NS).
ā¢ Mortality: 18.3% vs 19.0% (NS).
ā¢ 90d mRS shift: cOR 1.22 (1.01-1.48).
ā¢ sICH: 11.9% vs 19.4% (NS).
ā¢ Mortality: 18.3% vs 19.0% (NS).