Safety and efficacy of argatroban combined with antiplatelet therapy for acute mild-to-moderate ischemic stroke with large artery atherosclerosis
- VernacularTitle:阿加曲班联合抗血小板治疗急性轻中度大动脉粥样硬化型脑梗死的效果及安全性分析
- Author:
Jia YAN
1
;
Shuai YU
;
Hongxuan FENG
;
Huimin ZHAO
;
Xin TAN
;
Qian GUI
;
Guanhui WU
Author Information
- Keywords: argatroban; anticoagulation; cerebral infarction; large artery atherosclerosis; effi-cacy; safety
- From: Journal of Clinical Medicine in Practice 2024;28(19):89-94
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the effectiveness and safety of argatroban combined with an-tiplatelet therapy in patients with acute mild-to-moderate atherosclerotic cerebral infarction within 72 hours after symptom onset.Methods A total of 452 patients with large atherosclerotic cerebral infarc-tion were enrolled and divided into two groups.The combined therapy group(n=286)received ar-gatroban combined with antiplatelet therapy,while the control group(n=166)received antiplatelet therapy alone.The National Institutes of Health Stroke Scale(NIHSS)score,modified Rankin Scale(mRS)score,early neurological deterioration(END),and occurrence of bleeding events were com-pared between the two groups using a Logistic regression model.Results Statistically significant differences were observed in age,smoking history,time from stroke onset to admission,low-density lipo-protein,and estimated glomerular filtration rate(eGFR)levels between the two groups(P＜0.05).No significant differences were found in infarction location,responsible artery,and atherosclerotic subtype between the combined therapy and control groups(P＞0.05).Among patients with atheroscleroticcerebral infarction,the proportion of patients with an mRS score of 0 to 2 at 90 days after combined therapy of argatrobanwas 85.3％,and was 74.5％in the control group(P＜0.05).In patients with an NIHSS score ≥3,the proportion of patients with an mRS score of 0 to 2 at 90 days in the combined therapy group was 19.3％,which was significantly lower than 60.8％in the control group(P＜0.05).For anterior circulation responsible artery occlusion,the proportion of patients with an mRS score of 0 to 2 at 90 days in the combined therapy group was 82.1％,and 67.2％in the control group(P＜0.05).Among atherosclerotic subtypes,the proportion of patients with penetrating ar-tery occlusion and an mRS score of 0 to 2 at 90 days was significantly higher in the combined therapy group compared to the control group(P＜0.05).Conclusion Argatroban combined with anti-platelet therapy can improve neurological outcomes in patients with acute mild-to-moderate athero-sclerotic ischemic stroke without increasing the risk of bleeding.The combined therapy offers more pronounced benefits in patients with anterior circulation ischemia and penetrating artery occlusion.
