UMEM Educational Pearls

Category: Neurology

Title: Why Don't We Give GPIs in Acute Ischemic Stroke?

Keywords: antiplatelet, stroke, MI, Eptifibatide (PubMed Search)

Posted: 7/22/2015 by Danya Khoujah, MBBS
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Given the similarity in pathophysiology, pharmacologic treatments for ischemic stroke have been modeled after those for acute myocardial infarction, such as the use of antiplatelets and thrombolytic agents. Have you ever wondered, why don't we give glycoprotein IIb/IIIa inhibitors (GPIs) as well?
A Cochrane review answers this question; GPIs increase morbidity in acute ischemic stroke (in the form of intracranial hemorrhage), with no evidence of benefit (improvement in Rankin Scale).
The systematic review looked at randomized clinical trials of GPIs in patients with ischemic stroke of 6 hours or less, alone or in combination with thrombolytics.


Ciccone A, Motto C, Abraha I, et al. Glycoprotein IIb/IIIa Inhibitors for Acute Ischaemic Stroke. Cochrane Database Syst Rev. 2014;3