Evidence map›Paper›PMID 39757192›Full record

Trial reportBMC medicine2025

Effect of intravenous urokinase vs best medicine treatment on functional outcome for patients with acute minor stroke (TRUST): a randomized controlled trial.

Yongli Tao, Yuan Gao, Lu Zhao, Yafang Xu, Chenyang Jiang, Kai Liu, Hui Fang, Lulu Pei, Xin Wang, Rui Zhang and 17 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04420351 (A Phase ⅢB, Prospective, Randomized, Open Label, Blinded-endpoint, Multicenter Trial of the Efficacy and Safety of Urokinase Thrombolysis Comparing With Antiplatelet Agents for Patients With Minor Stroke.), which is not on this map. Cited by 9 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT04420351 phase3completednot on this map

A Phase ⅢB, Prospective, Randomized, Open Label, Blinded-endpoint, Multicenter Trial of the Efficacy and Safety of Urokinase Thrombolysis Comparing With Antiplatelet Agents for Patients With Minor Stroke.

TypeinterventionalSponsorThe First Affiliated Hospital of Zhengzhou UniversityRan2020 to 2023Enrolled1,005ConditionsMinor StrokeArmsUrokinase thrombolysis, Aspirin, Clopidogrel
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Article
  6. Article
  7. Article
  8. PA System in the Pathogenesis of Ischemic Stroke.Arteriosclerosis, thrombosis, and vascular biology · 2025
    Review
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Yongli TaoDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Yuan GaoDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Lu ZhaoDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Yafang XuDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Chenyang JiangDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Kai LiuDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Hui FangDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Lulu PeiDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Xin WangDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Rui ZhangDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Jun WuDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Jing YangDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Xinsheng HanDepartment of Neurology, Kaifeng Central Hospital, Kaifeng, China.
Hongling GuoDepartment of Neurology, Hua County People's Hospital, Anyang, China.
Baoguo XueDepartment of Neurology, Mengzhou Traditional Chinese Medicine Hospital, Jiaozuo, China.
Jinlou LiDepartment of Neurology, Linzhou People's Hospital, Anyang, China.
Yuqian LiuDepartment of Neurology, Tongbai County People's Hospital, Nanyang, China.
Hongqiu GuDepartment of Neurology, Tiantan Hospital, Capital Medical University, Beijing, China.
Kejin DuDepartment of Neurology, Tiantan Hospital, Capital Medical University, Beijing, China.
Xin ChengDepartment of Neurology, Huashan Hospital Affiliated to Fudan University, Shanghai, China.
Qiang DongDepartment of Neurology, Huashan Hospital Affiliated to Fudan University, Shanghai, China.
Duolao WangDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Ferdinando S BuonannoCardio-Neurology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
MingMing NingCardio-Neurology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Yuming XuDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. xuyuming@zzu.edu.cn.
Bo SongDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. fccsongb@zzu.edu.cn.
TRUST Trial Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe benefits of intravenous thrombolysis in patients with acute minor stroke remain controversial. For the aim of providing a better therapeutic strategy, high-quality trials are required to validate the efficacy of thrombolytic medicine other than intravenous recombinant tissue plasminogen and tenecteplase. In the trial, we evaluate the efficacy and safety of urokinase (UK) in acute minor stroke.

methodsThis multicenter, open-label, blinded-endpoint, randomized controlled clinical trial enrolled patients with minor stroke within 6 h of symptom onset, with a NIHSS score ≤ 5. The trial was conducted at 25 hospitals in China between October 2020 and February 2023. Eligible patients were randomized to the UK group (1,000,000 U) or the best medicine treatment group. The responsible investigator recommended and implemented the best medicine treatment based on guidelines. The primary endpoint was an excellent functional outcome, defined as a modified Rankin scale (mRS) score of 0-1 at 90 days. The primary safety outcome was symptomatic intracranial hemorrhage (sICH) within 36 h.

resultsA total of 999 patients were enrolled in the trial, the median age was 64 years, 371 (36.9%) were women; the median (IQR) NIHSS score was 3 (2-4). At 90 days, the primary endpoint was observed in 427 patients (84.9%) in the UK group and 425 patients (85.7%) in the control group (adjusted risk ratio [RR] 1.00, 95% CI 0.96-1.05, p = 0.87). A total of 3 patients in the UK-treated (0.6%) group experienced sICH compared to 1 patient (0.2%) in the control group (RR 1.83, 95% CI 0.16-20.27, p = 0.62).

conclusionsFor patients with acute minor stroke treated within 6 h of symptom onset, UK intravenous thrombolysis treatment was not found to be beneficial in terms of excellent functional outcome at 90 days, whereas it was safe.

trial registrationClinicalTrials.gov Identifier: NCT04420351.

Indexed as

Administration, IntravenousFibrinolytic AgentsStrokeUrokinase-Type Plasminogen ActivatorAgedChinaFemaleHumansMaleMiddle AgedThrombolytic TherapyTreatment OutcomeFibrinolytic AgentsUrokinase-Type Plasminogen ActivatorAntiplatelet therapyFunction outcomeIntravenous thrombolysisMinor strokeUrokinase

Identifiers

PMID39757192
PMCPMC11702182

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.