Trial reportJournal of the American Heart Association2025
Onset to Treatment Time and Early Neurological Deterioration of Dual Antiplatelet Therapy Versus Alteplase in Minor Stroke.
Trial report in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03661411 (Antiplatelet vs R-tPA for Acute Mild Ischemic Stroke), which is not on this map. Cited by 1 paper.
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.
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.
Antiplatelet vs R-tPA for Acute Mild Ischemic Stroke: a Prospective, Random, Blinded Assessment of Outcome and Open Label Multi-center Study
Who cites it
1 citing paper in PubMed.
- Early Neurological Deterioration in Subcortical Infarcts: A Narrative Review.Brain sciences · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe ARAMIS (Antiplatelet Versus R-tPA [Recombinant Tissue Plasminogen Activator] for Acute Minor Ischemic Stroke) trial established that dual antiplatelet therapy (DAPT) is noninferior to intravenous alteplase in patients with acute minor nondisabling ischemic stroke. In this prespecified secondary analysis, we aimed to evaluate whether onset-to-treatment time (OTT) modifies the treatment effect of DAPT versus alteplase on the risk of early neurological deterioration (END).
methodsUsing the as-treated population from ARAMIS, we included patients with acute minor nondisabling ischemic stroke who were treated within 4.5 hours of symptom onset. Participants were stratified by OTT into 2 groups: 0 to 3 and 3 to 4.5 hours. The primary end point was END, defined as an increase of ≥2 points on the National Institutes of Health Stroke Scale within 24 hours. The primary safety outcome was symptomatic intracranial hemorrhage. Treatment effects were assessed using binary logistic regression and generalized linear models.
resultsAmong 719 included patients, 362 (50.3%) were in the 0 to 3 hour group and 357 (49.7%) in the 3 to 4.5 hour group. DAPT was associated with a significantly lower incidence of END compared with alteplase in the 0 to 3 hour subgroup (2.6% versus 10.0%; adjusted
conclusionsAmong patients with acute minor ischemic stroke, OTT appears to modify the effect of DAPT versus alteplase on END. Earlier initiation of DAPT may be associated with a reduced risk of END compared with alteplase. REGISTRATION: URL: https://clinicaltrials.gov; Unique Identifier: NCT03661411.
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Registered trials
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.