Acute ischemic stroke
Conditions
Interventions
Part I (with severity intracranial arterial stenosis): antiplatelet group:1. Aspirin 300mg, QD+clopidogrel 75mg, QD in the first 24 hours. 2. 2. Aspirin 100mg, QD+clopidogrel 75mg, QD from 2-90 days.
Part I (with severity intracranial arterial stenosis): intravenous anticoagulation combined with antiplatelet group:1.intravenous argatroban 2.5mg/h within the first 48 hours and aspirin 100mg, QD
2. intravenous argatroban 2.5mg/h*4 hours, BID and aspirin 100mg, QD+clopidogrel 75mg, QD from 3-6 days
3.3. Aspirin 100mg, QD+clopidogrel 75mg, QD from 7-90 days.
Part II (with non-valvular atrial fibrillation): antiplatelet group:1.Aspirin 300mg, QD in the first 24 hours. 2.Aspirin 100mg, QD from 2-6 days. 3.Transition to oral anticoagulation therapy (new ora
Part II (with non-valvular atrial fibrillation): intravenous anticoagulation combined with antiplatelet group:1.intravenous argatroban 2.5mg/h within the first 48 hours and aspirin 100mg, QD. 2. intr
Sponsors
Department of Neurology, The Second Affiliated Hospital of Soochow University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Part I: Acute ischemic stroke with severity intracranial arterial stenosis: 1. Aged >18 years; 2. New acute ischemic stroke by MRI and with severity intracranial arterial stenosis defined as the stenosis =70% in Internal carotid artery, middle cerebral artery and anterior cerebral artery by MRA or CTA; 3. Admission NIHSS score =12; 4. Sudden onset of acute ischemic stroke with symptom onset to treatment (OTT) between 6 to 48 hours; 5. Partial anterior circulation syndrome according to OCSP classification; 6. First-ever stroke or history of stroke and pre-existing disability with mRS=1; 7. Signed (written) informed consent by the patient or the patient's legal representative and/or guardian. Part II: Acute ischemic stroke with Non-valvular Atrial fibrillation: 1. Aged >18 years; 2. New acute ischemic stroke by MRI and with Non-valvular Atrial fibrillation; 3. Admission NIHSS score =8; 4. Sudden onset of acute ischemic stroke with symptom onset to treatment (OTT) between 6 to 24 hours; 5. Partial anterior circulation syndrome according to OCSP classification; 6. First-ever stroke or history of stroke and pre-existing disability with mRS=1; 7. Signed (written) informed consent by the patient or the patient's legal representative and/or guardian.
Exclusion criteria
Exclusion criteria: Part I: Acute ischemic stroke with severity intracranial arterial stenosis 1. Hemorrhagic transformation after ischemic stroke; 2. Any anticoagulant treatment with in 7 days; 3. Patients given IV alteplase, mechanical thrombectomy or combine IV alteplase and mechanical thrombectomy treatment; 4. Unable to complete MRI; 5. Cardioembolic Stroke; 6. Known history of clinically significant hepatic dysfunction or liver disease, renal dysfunction; 7. Known history of hematologic or bleeding disease; 8. Non-atherosclerotic intracranial arterial stenosis, such as arterial dissection, arteritis; 9. Uncontrolled hypertension, SBP =180mmHg or DBP =110mmHg; 10. Admission INR>1.4, APTT>35s, Platelets1.4, APTT>35s, Platelets< 100x109/Lor glucose <2.7 mmol/L; 11. Patients with concurrent malignant tumor or undergoing anti-tumor therapy; 12. CT scan findings of hypoattenuation involving =1/3 of the MCA territory; 13. Active systemic hemorrhage, recent surgery or trauma or with in 30 days; 14. Pregnancy, lactation, or possible pregnancy and planned pregnancy; 15. Participated in other interventional clinical studies within 3 months or are participating in other intervention clinical studies; 16. The researchers considered the patients not suitable for this clinical study; 17. Previous intracranial hemorrhage, neoplasm, subarachnoid hemorrhage, or arterial venous malformation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| the new ischemic lesion on follow-up MRI ;the new intracranial hemorrhage on follow-up MRI ; | — |
Secondary
| Measure | Time frame |
|---|---|
| early neurological deterioration;NIHSS score and mRS score;new ischemic stroke;composite of major vascular events including stroke, myocardial infarction, and vascular death;the functional outcome: mRS score; | — |
Countries
China
Contacts
Public ContactYongjun Cao
Department of Neurology, the Second Affiliated Hospital of Soochow University
Outcome results
None listed