Tirofiban in Acute Ischemic Stroke: Mechanistic Rationale, Clinical Advances, and Emerging Therapeutic Strategies

Abstract

Tirofiban is a selective inhibitor of the glycoprotein IIb/IIIa receptor that reversibly prevents platelet aggregation and clot formation-processes central to the development and progression of ischemic stroke. Its use has been widely studied in both laboratory and clinical settings, particularly as an early intervention, a rescue option after failed mechanical thrombectomy, and in combination with clot-dissolving therapies. Emerging evidence supports tirofiban's role in preventing stroke progression, especially in high-risk groups such as older adults, women around menopause, patients with diabetes, liver or kidney dysfunction, and those who are pregnant. The drug has generally shown good safety and effectiveness in promoting blood flow restoration and improving long-term recovery. However, the most effective dosing, treatment scenarios, and patient profiles remain uncertain. Given its strong antiplatelet action and potential protective effects on brain tissue, tirofiban continues to gain interest as a treatment for acute ischemic stroke. This review summarizes key studies published since 2018, based on a structured literature search of PubMed, Embase, and Web of Science through May 2025, with the goal of guiding future research and improving clinical integration.