Erdun-Ujile plus tirofiban for progressive ischemic stroke: a single-centre retrospective cohort from Inner Mongolia

Abstract

Background & Objective: Progressive ischaemic stroke (PIS) is associated with early neurological worsening and poor outcome, and optimal acute management remains uncertain. In some centres, tirofiban is used as an off-label rescue antiplatelet strategy in selected patients, but evidence is still evolving. We evaluated the efficacy and safety of adding the Mongolian medicine Erdun-Ujile to tirofiban in patients with PIS in Inner Mongolia, China.

Methods: We retrospectively analysed 140 patients with PIS admitted between October 2022 and October 2024. Patients received Erdun-Ujile plus tirofiban (n=70) or tirofiban alone (n=70) for 14 days. Day-14 neurological deficit (NIHSS), disability (mRS), swallowing function (Kubota test), and overall clinical response were compared, together with changes in platelet-to-lymphocyte ratio (PLR), triglyceride–glucose (TyG) index, haemoglobin, and adverse events.

Results: Compared with tirofiban alone, Erdun-Ujile plus tirofiban was associated with greater 14-day improvement in NIHSS, mRS and Kubota scores and a higher overall response rate, without an increase in bleeding or other adverse events. Declines in PLR and TyG tended to favour the combination group, although between-group differences were not statistically significant.

Conclusions: In this retrospective cohort, adding Erdun-Ujile to tirofiban improved short-term neurological, functional and swallowing outcomes with acceptable safety. Erdun-Ujile may be a useful adjunctive therapy for progressive ischemic stroke in Asian settings and warrants confirmation in prospective trials.