CHANCE-4
(2025)Objective
To evaluate whether early IV tirofiban reduces recurrent stroke in patients with high-risk TIA/minor ischemic stroke and intracranial atherosclerosis
Study Summary
• Tirofiban did not reduce recurrent stroke compared to placebo (OR 1.00, 95% CI 0.83–1.22)
• Any bleeding increased with tirofiban (3.8% vs 1.5%)
• Severe bleeding remained rare and similar between groups (0.4% vs 0.3%)
• Any bleeding increased with tirofiban (3.8% vs 1.5%)
• Severe bleeding remained rare and similar between groups (0.4% vs 0.3%)
Intervention
IV tirofiban vs placebo in addition to standard medical therapy
Inclusion Criteria
High-risk TIA or minor ischemic stroke with intracranial atherosclerosis
Study Design
Arms: Tirofiban + standard therapy vs Placebo + standard therapy
Patients per Arm: 4,724 total (arm breakdown not specified)
Outcome
• Primary: Recurrent stroke OR 1.00 (95% CI 0.83–1.22) — neutral
• Severe bleeding: 0.4% vs 0.3% (similar)
• Any bleeding: 3.8% vs 1.5% (increased with tirofiban)
• Severe bleeding: 0.4% vs 0.3% (similar)
• Any bleeding: 3.8% vs 1.5% (increased with tirofiban)