ArticleBMJ open2021
Statin and dual antiplatelet therapy for the prevention of early neurological deterioration and recurrent stroke in branch atheromatous disease: a protocol for a prospective single-arm study using a historical control for comparison.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04824911 (Early Intensive Medical Therapy for the Prevention of Early Neurological Deterioration in Branch Atheromatous Disease), which is not on this map. Cited by 10 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Early Intensive Medical Therapy for the Prevention of Early Neurological Deterioration in Branch Atheromatous Disease
Who cites it
10 citing papers in PubMed, 15 citations in OpenAlex.
- Blood Pressure Variability and 90-Day Functional Outcome in Branch Atheromatous Disease-Related Stroke: A Multicenter Prospective Study.Journal of clinical hypertension (Greenwich, Conn.) · 2025Observational
- A Nomogram Incorporating Intracranial Atherosclerosis Score for Predicting Early Neurological Deterioration in Minor Stroke Patients With Type 2 Diabetes Mellitus.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Efficacy and safety of intravenous tenecteplase thrombolysis in diffusion-weighted imaging-negative posterior circulation ischemic stroke.Frontiers in neurology · 2025Article
- Early intensive therapy for preventing neurological deterioration in branch atheromatous disease.Therapeutic advances in neurological disorders · 2025Article
- Preliminary results on temporal evolution and clinical implications of atherosclerotic plaque in branch atheromatous disease after statin treatment.Therapeutic advances in neurological disorders · 2024Article
- Efficacy of Treatment with and without Initial Clopidogrel Loading in Branch Atheromatous Disease.Internal medicine (Tokyo, Japan) · 2023Article
- Pathophysiology and Optimal Treatment of Intracranial Branch Atheromatous Disease.Journal of atherosclerosis and thrombosis · 2023Review
- Early blood pressure changes during systemic thrombolysis and its association with unexplained early neurological deterioration in small subcortical infarct.Journal of clinical hypertension (Greenwich, Conn.) · 2022Article
- Article
- Relationship between the stroke mechanism of symptomatic middle cerebral artery atherosclerotic diseases and culprit plaques based on high-resolution vessel wall imaging.Frontiers in neurology · 2022Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionBranch atheromatous disease (BAD) contributes to small-vessel occlusion in cases of occlusion or stenosis of large calibre penetrating arteries, and it is associated with a higher possibility of early neurological deterioration (END) and recurrent stroke in acute ischaemic stroke. As the pathology of BAD is due to atherosclerosis, we postulate that early intensive medical treatment with dual antiplatelet therapy (DAPT) and high-intensity statins may prevent END and recurrent stroke in acute small subcortical infarction caused by BAD. METHODS AND ANALYSIS: In this prospective, single-centre, open-label, non-randomised, single-arm study using a historical control, we will compare early DAPT and high-intensity statin treatment with a historical control group of patients with BAD who were treated with single antiplatelet therapy without high-intensity statin treatment. Patients will be eligible for enrolment if they are admitted for acute ischaemic stroke within 24 hours, have a National Institutes of Health Stroke Scale (NIHSS) score of 1-8 and are diagnosed with BAD by MRI. Patients will take aspirin, clopidogrel and high-intensity statins (atorvastatin or rosuvastatin) within 24 hours of stroke onset, followed by aspirin or clopidogrel alone from day 22. The primary endpoint is the percentage of patients who develop END within 7 days of stroke onset (defined as an increase in the NIHSS score ≥2 points) and recurrent stroke within 30 days. The total sample sizes will be 138 for the intervention group and 277 for the control group. A historical control group will be drawn from previous prospective observation studies. ETHICS AND DISSEMINATION: The protocol of this study has been approved by the Institutional Review Board of Chang Gung Memorial Hospital (202001386A3). All participants will have to sign and date an informed consent form. The findings arising from this study will be disseminated in peer-reviewed journals and academic conferences. TRIAL REGISTRATION NUMBER: NCT04824911.
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