Evidence map›Paper›PMID 39647919›Full record

Trial reportStroke and vascular neurology2025

Baseline systolic blood pressure and efficacy of dual antiplatelet in acute ischaemic stroke.

Yu Cui, Yue Wang, Hui-Sheng Chen

Abstract readRandomized Controlled TrialMulticenter StudyComparative Study
In one paragraph

Trial report in Stroke and vascular neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Effect of prior antiplatelet therapy on recurrence in patients with acute cerebral ischaemia: data from the triple antiplatelets for reducing dependency after ischaemic stroke (TARDIS) randomised trial.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Trial
  2. Article
  3. Article
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

3 authors.

Yu CuiDepartment of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.ORCID 0000-0002-4925-1500
Yue WangDepartment of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.
Hui-Sheng ChenDepartment of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China chszh@aliyun.com.ORCID 0000-0002-7486-1992

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSystolic blood pressure (SBP) affects the risk of early neurological deterioration (END). This subgroup analysis of Antiplatelet Therapy in Acute Mild to Moderate Ischemic Stroke (ATAMIS) trial aimed to explore whether SBP at admission affected the efficacy of different antiplatelet therapies in preventing END.

methodsBased on the modified intention-to-treat analysis set of the ATAMIS trial, patients were divided into two subgroups according to whether SBP at admission was equal to or higher than 140 mm Hg, which were further subdivided into clopidogrel plus aspirin and aspirin alone treatments according to the randomised assignment. We conducted multivariable regression analyses to detect relationship between SBP at admission and END, as well as efficacy of different antiplatelet therapies in each SBP subgroup. Primary endpoint was END defined as ≥2-point increase in 7-day National Institutes of Health Stroke Scale score. Safety endpoints included intracranial haemorrhage and bleeding events during the trial.

resultsThis study included 2915 patients. Risk of END raised by 16% as SBP at admission increased by every 10 mm Hg (p<0.001). Clopidogrel plus aspirin resulted in significantly lower risk of END than aspirin alone in patients with SBP≥140 mm Hg (5.5% vs 7.9%; adjusted risk difference (RD) and 95% CI -2.5% (-4.1% to -1.0%)), but not in those with SBP<140 mm Hg (3.4% vs 4.2%; adjusted RD and 95% CI -0.8% (-3.2% to 1.7%)). Efficacy of different antiplatelet therapies and SBP did not show significant interaction (p=0.50). Safety endpoints were similar between treatments in SBP subgroups.

conclusionThe risk of END increases with elevated SBP at admission among patients with acute mild-to-moderate ischaemic stroke who are not suitable for reperfusion treatments. Fewer END occurred following clopidogrel plus aspirin compared with aspirin alone across different SBP levels. The finding should be interpreted cautiously.

Indexed as

AspirinBlood PressureClopidogrelDual Anti-Platelet TherapyHypertensionIschemic StrokePlatelet Aggregation InhibitorsAgedAged, 80 and overDisability EvaluationDrug Therapy, CombinationFemaleHumansIntention to Treat AnalysisIntracranial HemorrhagesMaleAspirinClopidogrelPlatelet Aggregation InhibitorsBlood PressureStroke

Identifiers

PMID39647919
PMCPMC12415644

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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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 Socratic graph.