Objective To investigate the effect of tirofiban combined with oxiracetam on acute anterior circulation progressive cerebral infarction.

Methods A total of 171 patients with acute anterior circulation progressive cerebral infarction from October 2022 to January 2024 were enrolled and randomly divided into three groups using a random number table. The control group of 57 patients received conventional treatment, the observation group A received tirofiban in addition to conventional treatment, and the observation group B received oxiracetam on the basis of observation group A's treatment. The effectiveness indicators including the rates of neurological improvement and neurological deterioration at 14 days after treatment, the rate of good prognosis and modified Rankin Scale (MRS) scores at 90 days after treatment, as well as the National Institutes of Health Stroke Scale (NIHSS) scores at 7 and 14 days after treatment and their differences from baseline, cognitive function assessed using the Montreal Cognitive Assessment (MOCA), and safety indicators (incidence rates of symptomatic intracranial hemorrhage, fatal intracranial hemorrhage, and mortality at 90 days after treatment) were compared among the three groups.

Results There were no statistically significant differences in the rates of neurological improvement and neurological deterioration at 14 days after treatment, the rate of good prognosis, and MRS scores at 90 days after treatment among the three groups (P>0.05). There were statistically significant differences in NIHSS scores between baseline and 7 and 14 days after treatment in all three groups (P < 0.05), and the differences in NIHSS scores from baseline at the above time points were higher in observation group B than in observation group A and the control group (P < 0.05). There were no statistically significant differences in MOCA scores among the three groups before treatment (P>0.05); however, the MOCA scores in the observation group B were higher than those in observation group A and the control group at 14, 30, and 90 days after treatment (P < 0.05). There were no statistically significant differences in the incidence rates of symptomatic intracranial hemorrhage, fatal intracranial hemorrhage, and mortality at 90 days after treatment among the three groups (P>0.05).

Conclusion Tirofiban combined with oxiracetam can improve cognitive function in patients with acute anterior circulation progressive cerebral infarction without increasing the risk of hemorrhage, and has better prognosis.