ArticleBMC neurology2021
Early argatroban and antiplatelet combination therapy in acute non-lacunar single subcortical infarct associated with mild intracranial atherosclerosis.
Article in BMC neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Exploring the Efficacy and Safety of Argatroban as an Adjunct to Antiplatelet Therapy in Ischemic Stroke Patients: A Systematic Review and Meta-analysis.Translational stroke research · 2025Pooled it
- Pooled it
- Efficacy and safety of Argatroban in patients with acute ischemic stroke: a systematic review and meta-analysis.Frontiers in neurology · 2024Pooled it
- Mechanism-Oriented Treatment of Early Neurologic Deterioration in Acute Ischemic Stroke.Journal of stroke · 2026Review
- Timely Initiation of Argatroban Improves Prognosis in Patients With Acute Ischemic Stroke Attributed to Large Artery Atherosclerosis: A Cohort Study.Brain and behavior · 2025Article
- Rescue therapy of early neurological deterioration in lacunar stroke.BMC neurology · 2024Article
- Relative score of early neurological deterioration in perforator artery infarction: a retrospective study.BMC neurology · 2024Article
- Efficacy and safety of Agatroban in improving the prognosis of ischemic stroke patients.American journal of translational research · 2023Article
- Risk factors for early neurological deterioration in acute isolated pontine infarction without any causative artery stenosis.BMC neurology · 2022Article
- Carotid Siphon Calcification Predicts the Symptomatic Progression in Branch Artery Disease With Intracranial Artery Stenosis-Brief Report.Arteriosclerosis, thrombosis, and vascular biology · 2022Article
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with acute non-lacunar single subcortical infarct (SSI) associated with mild intracranial atherosclerosis (ICAS) have a relatively high incidence of early neurological deterioration (END), resulting in unfavorable functional outcomes. Whether the early administration of argatroban and aspirin or clopidogrel within 6-12 h after symptom onset is effective and safe in these patients is unknown.
methodsA review of the stroke database of Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University and Qingdao Center Hospital, Qingdao University Medical College in China was undertaken from May 2017 to January 2020 to identify all patients with non-lacunar SSI caused by ICAS within 6-12 h of symptom onset based on MRI screening. Patients were divided into two groups, one comprising those who received argatroban and mono antiplatelet therapy with aspirin or clopidogrel on admission (argatroban group), and the other those who received dual antiplatelet therapy (DAPT) with aspirin and clopidogrel during hospitalization (DAPT group). The primary outcome was recovery by 90 days after stroke based on a modified Rankin scale (mRS) score (0 to 1). The secondary outcome was END incidence within 120 h of admission. Safety outcomes were intracranial hemorrhage (ICH) and major extracranial bleeding. The probability of clinical benefit (mRS score 0-1 at 90 days) was estimated using multivariable logistic regression analysis.
resultsA total of 304 acute non-lacunar SSI associated with mild ICAS patients were analyzed. At 90 days, 101 (74.2%) patients in the argatroban group and 80 (47.6%) in the DAPT group had an mRS score that improved from 0 to 1 (P < 0.001). The relative risk (95% credible interval) for an mRS score improving from 0 to 1 in the argatroban group was 1.50 (1.05-2.70). END occurred in 10 (7.3%) patients in the argatroban group compared with 37 (22.0%) in the DAPT group (P < 0.001). No patients experienced symptomatic hemorrhagic transformation.
conclusionsEarly combined administration of argatroban and an antiplatelet agent (aspirin or clopidogrel) may be beneficial for patients with non-lacunar SSI associated with mild ICAS identified by MRI screening and may attenuate progressive neurological deficits.
trial registrationOur study is a retrospectively registered trial.
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