Efficacy and safety of argatroban or low molecular weight heparin plus aspirin in early progressive ischemic stroke
MIN Jingjing1, CHEN Qi2, PAN Mengxiong1, LIU Tan1, SUN Ru1.
1.Department of Neurology, the First People’s Hospital of Huzhou, the First Affiliated Hospital of Huzhou University, Huzhou 313000, China; 2.Department of Nephrology, the First People’s Hospital of Huzhou, the First Affiliated Hospital of Huzhou University, Huzhou 313000, China
MIN Jingjing,CHEN Qi,PAN Mengxiong, et al. Efficacy and safety of argatroban or low molecular weight heparin plus aspirin in early progressive ischemic stroke[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2023, 53(2): 115-120.
Abstract：Objective: To observe and compare the efficacy and safety of aspirin combined with argatroban or low molecular weight heparin (LMWH) in the progressive ischemic stroke (PIS). Methods: 95 patients with PIS who met the criteria were randomly divided into two groups, 48 cases in the argatroban plus aspirin group (AA group) and 47 cases in the LMWH plus aspirin group (LA group). The National Institutes of Health Stroke Scale (NIHSS) score, the Activities of Daily Living (Barthel) index, and the modified Rankin Scale (mRS) score were compared between the two groups before and after treatment. At the same time, the hemoglobin (Hb) concentration, platelet (PLT) count, activated partial prothrombin time (APTT), high-sensitivity C-reactive protein (hs-CRP) concentration, and the occurrence of adverse drug reactions were monitored. Results: After 7 days of treatment, both groups had certain efficacy compared with those before treatment. The total effective rate of AA group was significantly higher than that of LA group (P<0.05). After treatment, the NIHSS score in the AA group was significantly lower than that in the LA group (P<0.05), and the Barthel index was significantly increased than the LA group (P<0.01). The mRS score in the AA group was significantly reduced than that in the LA group after 3 months of treatment (P<0.01). Moreover, compared with the mRS0-1 score at 3 months of treatment, argatroban was superior to the LMWH (P<0.05). Meanwhile, the APTT in the AA group was longer than that in the LA group after treatment (P<0.01) and the PLT in the LA group was reduced than AA group (P<0.01). There was no significant difference in Hb between the two groups after treatment (P>0.05). The adverse reactions of AA group and LA group were 4.17% and 8.51%, respectively, with no significant statistical difference (P>0.05).Conclusion: For patients with PIS, aspirin plus argatroban or LMWH both can improve the clinical symptoms and the risk of bleeding is low. In comparison, argatroban can better promote the recovery of neurological deficits and improve the ability of daily living, without increasing the adverse reactions of drugs.
