Early antiplatelet treatment for minor stroke following thrombolysis: the EAST trial.

This study aimed to investigate the potential benefit of early antiplatelet after intravenous thrombolysis in minor stroke.

本研究旨在探讨在小卒中后早期使用抗血小板治疗的潜在益处。

Methods

A multicentre, double-blind, randomized trial was conducted in China between 7 August 2022 and 1 August 2024, to evaluate the efficacy and safety of early antiplatelet in acute ischaemic stroke patients presenting with mild neurological deficits, as indicated by a National Institutes of Health Stroke Scale (NIHSS) score of 0-5, who received intravenous thrombolysis.

在中国，于2022年8月7日至2024年8月1日进行了一项多中心、双盲、随机试验，旨在评估在急性缺血性中风患者中早期使用抗血小板药物的有效性和安全性，这些患者表现为轻度神经系统缺损，根据美国国立卫生研究院卒中量表（NIHSS）评分为0-5，并接受了静脉溶栓治疗。

Patients were randomly assigned to receive either clopidogrel and aspirin or placebo within 6 h after intravenous thrombolysis.

患者在静脉溶栓治疗后6小时内随机分配接受氯吡格雷和阿司匹林或安慰剂治疗。

The primary endpoint was an excellent functional outcome at 90 days, indicated by a modified Rankin Scale (mRS) score of 0-1.

主要终点是90天时极好的功能结果，表现为改良Rankin量表（mRS）评分为0-1。

Statistical analysis was based on a modified intention-to-treatpopulation.

统计分析基于改良意向治疗人群。

Symptomatic intracranial haemorrhage, any intracranial haemorrhage, and major systemic bleeding were safety endpoints.

症状性颅内出血、任何颅内出血和主要系统性出血是安全性终点。

Results

The primary endpoint was not met in this study.

本研究未达到主要终点。

Of the randomly assigned 1022 patients, 995 patients were included in the modified intention-to-treatanalysis (503 with early antiplatelet treatment and 492 with placebo).

在随机分配的1022名患者中，有995名患者被纳入改良意向治疗分析（503名接受早期抗血小板治疗，492名接受安慰剂）。

The primary endpoint occurred in 89.7% (451/503) of patients receiving early antiplatelet vs 89.6% (441/492) of those receiving placebo with no significant difference (odds ratio 1.00, 95% confidence interval.67-1.51, P = .99).

主要终点事件在89.7%（451/503）接受早期抗血小板治疗的患者和89.6%（441/492）接受安慰剂的患者中发生，两者之间没有显著差异（比值比1.00，95%置信区间0.67-1.51，P = .99）。

Similar safety profiles were found between the two groups.

两组之间发现了相似的安全性特征。

Conclusions

Among Chinese patients with acute minor ischaemic stroke who received intravenous thrombolysis, early antiplatelet treatment with clopidogrel plus aspirin was safe but did not improve already excellent functional outcome (mRS 0-1) at 90 days.

在接收静脉溶栓治疗的中国急性轻度缺血性中风患者中，早期使用氯吡格雷加阿司匹林的抗血小板治疗是安全的，但并未改善已经非常好的90天功能结果（mRS 0-1）。