Evidence mapPaperPMID 41005788Full record

Observational studyStroke and vascular neurology2026

Intravenous thrombolysis versus early antiplatelet therapy in acute ischaemic stroke with small artery occlusion.

Ke Zhang, Hongbing Liu, Ce Zong, Yapeng Li, Kai Liu, Yusheng Li, Jing Yang, Bo Song, Yuming Xu, Yuan Gao

Abstract readMulticenter StudyComparative StudyObservational Study
In one paragraph

Observational study in Stroke and vascular neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Ke Zhang *Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Hongbing Liu *Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Ce ZongDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.ORCID http://orcid.org/0000-0003-0282-0769
Yapeng LiDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Kai LiuDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Yusheng LiDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Jing YangDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Bo SongDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China fccgaoy1@zzu.edu.cn xuyuming@zzu.edu.cn fccsongb@zzu.edu.cn.ORCID http://orcid.org/0000-0002-4563-0781
Yuming XuDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China fccgaoy1@zzu.edu.cn xuyuming@zzu.edu.cn fccsongb@zzu.edu.cn.ORCID http://orcid.org/0000-0003-2689-9897
Yuan GaoDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China fccgaoy1@zzu.edu.cn xuyuming@zzu.edu.cn fccsongb@zzu.edu.cn.ORCID http://orcid.org/0000-0003-2596-4773

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe efficacy of intravenous thrombolysis (IVT) versus early antiplatelet therapy (APT) in small artery occlusion (SAO) stroke remains debated.

methodsIschaemic stroke (IS) patients with SAO who received IVT or early APT without IVT≤4.5 hours from stroke onset were screened from a prospective multicentre IS registry study from 1 January to 1 June 2021. The primary outcome was unfavourable functional outcome (FO) at 3 months. The secondary outcome was early neurological deterioration (END). The safety outcome was symptomatic intracerebral haemorrhage (sICH).

resultsThere were 1125 SAO patients with 394 receiving IVT. 411 patients (36.5%) exhibited unfavourable FO, and sICH occurred in 3 cases (0.27%), all in IVT group, at the follow-up. END was observed in 213 patients (18.9%). After propensity score matching and multivariable adjustment, IVT significantly reduced the likelihood of unfavourable FO at 3 months (aOR 0.447, 95% CI 0.305 to 0.656), but no significant difference was found in END (aOR 0.867, 95% CI 0.569 to 1.321). Clustering analysis identified two distinct phenotypes: phenotype 0 (characterised by traditional cardiovascular risk factors) and phenotype 1 (marked by prominent inflammatory markers). A significant treatment-by-phenotype interaction was observed (p=0.002), with a comparable magnitude of benefit in phenotype 0 (aOR 0.405, 95% CI 0.244 to 0.673) compared with phenotype 1 (aOR 0.414, 95% CI 0.218 to 0.783).

conclusionIVT significantly reduced the likelihood of unfavourable FO at 3 months in SAO patients but did not significantly reduce END. Patients with traditional risk factors may benefit more from IVT than those with elevated inflammatory markers. TRIAL REGISTRATION NUMBER: ChiCTR2100045258.

Indexed as

Fibrinolytic AgentsIschemic StrokePlatelet Aggregation InhibitorsThrombolytic TherapyAdministration, IntravenousAgedAged, 80 and overFemaleFunctional StatusHumansMaleMiddle AgedProspective StudiesRecovery of FunctionRegistriesRisk AssessmentFibrinolytic AgentsPlatelet Aggregation InhibitorsIschemic StrokeStrokeThrombolytic Therapy

Identifiers

PMID41005788
PMCPMC13347813

What Socratic holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

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.