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In patients who had a stroke or TIA, enlarged perivascular spaces in basal ganglia may cause future haemorrhagic strokes

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Stroke & Vascular Neurology 2024年第1期9卷 8-17,I0001-I0033页

作者： Yu Tian Mengxing Wang Yuesong Pan Xia Meng xingquan zhao Liping Liu Yongjun Wang Yilong Wang Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Chinese Institute for Brain Research BeijingChina National Center for Neurological Diseases BeijingChina Advanced Innovation Center for Human Brain Protection Capital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases BeijingChina

Introduction It remains unclear whether enlarged perivascular spaces(EPVS)predict poor clinical outcomes in patients with acute ischaemic stroke(AIS)or transient ischaemic attack(TIA).Method Data were obtained from the Third China National Stroke Registry study.We estimated EPVS in basal ganglia(BG)and centrum semiovale(CSO)using a semiquantified scale(Grade from 0 to 4).Using Cox and logistic regression analyses,the associations of EPVS with 3-month and 1-year adverse outcomes(including recurrent stroke,ischaemic stroke,haemorrhagic stroke,combined vascular event,disability and mortality)were explored.Sensitivity analyses of any association of cerebral small vessel disease at baseline and development of a small arterial occlusion(SAO)were conducted.Result Among 12603 patients with AIS/TIA,median age was 61.7±11.6 years,and 68.2%were men.After adjusting for all potential confounders,frequent-to-severe BG-EPVS was associated with a decreased risk of recurrent ischaemic stroke(HR 0.71,95%CI 0.55 to 0.92,p=0.01)but an increased risk of haemorrhagic stroke(HR 1.99,95%CI 1.11 to 3.58,p=0.02)at 1 year after AIS/TIA,compared with none-to-mild BG-EPVS.Patients with frequent-to-severe CSO-EPVS had a decreased risk of disability(OR 0.76,95%CI 0.62 to 0.92,p=0.004)and all-cause death(HR 0.55,95%CI 0.31 to 0.98,p=0.04)within 3-month but not 1-year follow-ups,compared with those with none-to-mild BG-EPVS.Sensitivity analyses showed that both BG-EPVS(HR 0.43,95%CI 0.21 to 0.87,p=0.02)and CSO-EPVS(HR 0.58,95%CI 0.35 to 0.95,p=0.03)were associated with a decreased risk of subsequent ischaemic stroke in patients with SAO during 1-year follow-up.Conclusion BG-EPVS increased the risk of haemorrhagic stroke in patients already with AIS/TIA within 1 year.Therefore,caution is recommended when selecting antithrombotic agents for secondary stroke prevention in patients with AIS/TIA and more severe BG-EPVS.

关键词： patients haemorrhagic prevention

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Tirofiban combined with Aspirin in the Treatment of Acute Penetrating Artery Territory Infarction (STRATEGY): protocol for a multicentre, randomised controlled trial

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Stroke & Vascular Neurology 2024年第1期9卷 75-81,I0047-I0052页

作者： Xiaoling Liao Shuo Feng Yicong Wang Yuesong Pan Weiqi Chen Hui Qu xingquan zhao Liping Liu Yongjun Wang Yilong Wang Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases Beijing TiantanHospitalCapital Medical UniversityBeijingChina Chinese Institute for Brain Research BeijingChina National Center for Neurological Diseases BeijingChina Advanced Innovation Center for Human Brain Protection Capital Medical UniversityBeijingChina Beijing Laboratory of Oral Health Capital Medical UniversityBeijingChina

Background Perforating artery territorial infarction(PAI)caused by branch atheromatous disease(BAD)is prone to recurrence and early progression without an effective and well-documented antiplatelet treatment regimen.Tirofiban,an adjunctive antiplatelet agent,has shown great potential to treat acute ischaemic stroke.However,whether the combination of tirofiban and aspirin can improve the prognosis of PAI remains unclear.Aim To explore an effective and safe antiplatelet regimen for reducing the risk of recurrence and early neurological deterioration(END)in PAI caused by BAD by comparing the tirofiban and aspirin combination with placebo and aspirin combination.Methods Tirofiban combined with Aspirin in the Treatment of Acute Penetrating Artery Territory Infarction(STRATEGY)trial is an ongoing multicentre,randomised,placebo-controlled trial in China.Eligible patients shall be randomly assigned to receive standard aspirin with tirofiban or placebo on the first day and standard aspirin from days 2 to 90.The primary endpoint is a new stroke or END within 90 days.The primary safety endpoint is severe or moderate bleeding within 90 days.Discussion The STRATEGY trial will assess whether tirofiban combined with aspirin is effective and safe in preventing recurrence and END in patients with PAI.Trial registration number NCT05310968.

关键词： Aspirin regimen centre

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Rationale and design of Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events III (TRACE III): a randomised, phase III, open- label, controlled trial

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Stroke & Vascular Neurology 2024年第1期9卷 82-89页

作者： Yunyun Xiong Bruce C V Campbell Marc Fisher Lee H Schwamm Mark Parsons Hao Li Yuesong Pan Xia Meng xingquan zhao Yongjun Wang Neurology Beijing Tiantan HospitalBeijingChina China National Clinical Research Center for Neurological Diseases BeijingChina Department of Medicine and Neurology The University of MelbourneMelbourneVictoriaAustralia Neurology Beth Israel Deaconess Medical CenterBostonMassachusettsUSA Department of Neurology and Comprehensive Stroke Center Massachusetts General HospitalBostonMassachusettsUSA Department of Neurology University of New South Wales South Western Sydney Clinical SchoolLiverpoolNew South WalesAustralia

Background and purpose Recombinant human TNK tissue-type plasminogen activator(rhTNK-tPA)was not inferior to alteplase for ischaemic stroke within 4.5hours.Our study aimed to investigate the efficacy and safety of rhTNK-tPA in patients who had an ischaemic stroke due to large vessel occlusion(LVO)of anterior circulation beyond 4.5hours.Methods and design Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events-III(TRACE III)is a multicentre,prospective,randomised,open-label,blind endpoint,controlled clinical trial.Patients who had an ischaemic stroke due to anterior circulation LVO(internal carotid artery,middle cerebral artery M1 and M2 segments)within 4.5–24hours from last known well(including wake-up stroke and no witness stroke)and with salvageable tissue(ischaemic core volume6s at 24 hours and NIHSS score change from baseline at 7days.Safety outcomes are symptomatic intracerebral haemorrhage within 36 hours and mortality at 90 days.Discussion TRACE III will provide evidence for the efficacy and safety of rhTNK-tPA in patients who had an ischaemic strokes due to anterior circulation LVO beyond 4.5hours.Trial registration number NCT05141305.

关键词： Therapy random Rational

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Balloon Angioplasty for Symptomatic Intracranial Artery Stenosis (BASIS): protocol of a prospective, multicentre, randomised, controlled trial

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Stroke & Vascular Neurology 2024年第1期9卷 66-74页

作者： Xuan Sun Ming Yang Dapeng Sun Guangge Peng Yiming Deng xingquan zhao Liping Liu Ning Ma Feng Gao Dapeng Mo Wengui Yu Yongjun Wang Yilong Wang Zhongrong Miao Department of Interventional Neuroradiology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Neurology Beijing Luhe HospitalCapital Medical UniversityBeijingChina Department of Neurology Comprehensive Stroke&Cerebrovascular CenterUniversity of California IrvineIrvineCaliforniaUSA Chinese Institute for Brain Research BeijingChina National Center for Neurological Diseases BeijingChina Advanced Innovation Center for Human Brain Protection Capital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases BeijingChina Beijing Laboratory of Oral Health Capital Medical UniversityBeijingChina

Background The superiority of balloon angioplasty plus aggressive medical management(AMM)to AMM alone for symptomatic intracranial artery stenosis(sICAS)on efficacy and safety profiles still lacks evidence from randomised controlled trials(RCTs).Aim To demonstrate the design of an RCT on balloon angioplasty plus AMM for sICAS.Design Balloon Angioplasty for Symptomatic Intracranial Artery Stenosis(BASIS)trial is a multicentre,prospective,randomised,open-label,blinded end-point trial to investigate whether balloon angioplasty plus AMM could improve clinical outcome compared with AMM alone in patients with sICAS.Patients eligible in BASIS were 35–80 years old,with a recent transient ischaemic attack within the past 90 days or ischaemic stroke between 14 days and 90 days prior to enrolment due to severe atherosclerotic stenosis(70%–99%)of a major intracranial artery.The eligible patients were randomly assigned to receive balloon angioplasty plus AMM or AMM alone at a 1:1 ratio.Both groups will receive identical AMM,including standard dual antiplatelet therapy for 90 days followed by long-term single antiplatelet therapy,intensive risk factor management and life-style modification.All participants will be followed up for 3years.Study outcomes Stroke or death in the next 30 days after enrolment or after balloon angioplasty procedure of the qualifying lesion during follow-up,or any ischaemic stroke or revascularisation from the qualifying artery after 30 days but before 12 months of enrolment,is the primary outcome.Discussion BASIS trail is the first RCT to compare the efficacy and safety of balloon angioplasty plus AMM to AMM alone in sICAS patients,which may provide an alternative perspective for treating sICAS.Trial registration number NCT03703635;https://www.***.gov.

关键词： balloon prospective centre

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Night-time diastolic blood pressure variability relates to stroke recurrence in patients who had ischaemic stroke with small artery occlusion

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Stroke & Vascular Neurology 2022年第3期7卷 237-244页

作者： Tingting Wang Jie Xu Anxin Wang Ying Liu xingquan zhao Yongjun Wang Yilong Wang Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases BeijingChina

Background and purpose The association between blood pressure variability(BPV)and stroke recurrence among patients who had ischaemic stroke(IS)remains unclear.This study aimed to investigate the association between BPV and stroke recurrence in patients who had IS of large artery atherosclerosis(LAA)subtype and small artery occlusion(SAO)subtype.Methods Data from the BOSS(Blood Pressure and Clinical Outcome in Transient Ischemic Attack or Ischemic Stroke)study were examined.IS subtypes were diagnosed according to the Trial of Org 10172 in Acute Stroke Treatment criteria.BPV was performed by 24-hour ambulatory blood pressure monitoring and defined through SD of blood pressure.The primary outcome was stroke recurrence within 90 days after discharge.Multivariable Cox regression model was used to assess the association between BPV and stroke recurrence in patients who had IS of LAA subtype and SAO subtype.Results A total of 1390 patients who had IS from the BOSS study were included in the present study.Multivariable analysis suggests that 24-hour systolic BPV(SBPV)and night-time diastolic BPV(DBPV)were significantly associated with stroke recurrence among all patients who had IS(HR,2.50,95%CI 1.07 to 5.84;HR,1.85,95%CI 1.07 to 3.21,respectively).Night-time SBPV and night-time DBPV were significantly associated with stroke recurrence in patients with SAO subtype(HR,2.77,95%CI 1.07 to 7.15;HR,3.60,95%CI 1.39 to 9.29,respectively).However,in the adjusted model,only night-time DBPV remained significant in patients with SAO subtype(HR,3.87,95%CI 1.40 to 10.71).Similar results were not found in patients who had IS of LAA subtype.Conclusions High night-time DBPV was associated with increased risk of stroke recurrence among patients who had IS of SAO subtype.The results of this study have implications for the secondary prevention management and future research of patients who had IS of SAO subtype.The association between BPV and stroke recurrence in patients who had IS of LAA subtype and SAO subtype should be investigated in

关键词： patients diastolic Blood

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Biomarker and genomic analyses reveal molecular signatures of non-cardioembolic ischemic stroke

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Signal Transduction and Targeted Therapy 2023年第6期8卷 3168-3183页

作者： Lingling Ding Yu Liu Xia Meng Yong Jiang Jinxi Lin Si Cheng Zhe Xu xingquan zhao Hao Li Yongjun Wang Zixiao Li Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijing100070China China National Clinical Research Center for Neurological Diseases Beijing100070China Research Unit of Artificial Intelligence in Cerebrovascular Disease Chinese Academy of Medical SciencesBeijing100070China Center for Excellence in Brain Science and Intelligence Technology Chinese Academy of SciencesShanghai200031China Advanced Innovation Center for Human Brain Protection Capital Medical UniversityBeijing100070China Clinical Center for Precision Medicine in Stroke Capital Medical UniversityBeijing100070China Chinese Institute for Brain Research BeijingChina Beijing Engineering Research Center of Digital Healthcare for Neurological Diseases Beijing100070China

Acute ischemic stroke(AIS)is a major cause of disability and mortality worldwide.Non-cardioembolic ischemic stroke(NCIS),which constitutes the majority of AIS cases,is highly heterogeneous,thus requiring precision medicine treatments.This study aimed to investigate the molecular mechanisms underlying NCIS heterogeneity.We integrated data from the Third China National Stroke Registry,including clinical phenotypes,biomarkers,and whole-genome sequencing data for 7695 patients with NCIS.We identified 30 molecular clusters based on 63 biomarkers and explored the comprehensive landscape of biological heterogeneity and subpopulations in NCIS.Dimensionality reduction revealed fine-scale subpopulation structures associated with specific biomarkers.The subpopulations with biomarkers for inflammation,abnormal liver and kidney function,homocysteine metabolism,lipid metabolism,and gut microbiota metabolism were associated with a high risk of unfavorable clinical outcomes,including stroke recurrence,disability,and mortality.Several genes encoding potential drug targets were identified as putative causal genes that drive the clusters,such as CDK10,ERCC3,and CHEK2.We comprehensively characterized the genetic architecture of these subpopulations,identified their molecular signatures,and revealed the potential of the polybiomarkers and polygenic prediction for assessing clinical outcomes.Our study demonstrates the power of large-scale molecular biomarkers and genomics to understand the underlying biological mechanisms of and advance precision medicine for NCIS.

关键词： metabolism mortality Acute

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Safety and efficacy of tenecteplase versus alteplase in patients with acute ischaemic stroke (TRACE): a multicentre, randomised, open label, blinded-endpoint (PROBE) controlled phase II study

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Stroke & Vascular Neurology 2022年第1期7卷 47-53页

作者： Shuya Li Yuesong Pan Ziran Wang Zhigang Liang Huisheng Chen Dong Wang Yi Sui xingquan zhao Yilong Wang WanLiang Du Huaguang Zheng Yongjun Wang China National Clinical Research Center for Neurological Diseases Beijing Tiantan HospitalBeijingChina Department of Neurology Beijing Tiantan HospitalBeijingChina Department of Neurology Linyi People's HospitalLinyiChina Department of Neurology Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical CollegeYanTaiChina Department of Neurology General Hospital of Northern Theatre CommandShenyangLiaoningChina Department of Neurology Baogang Hospital of Inner MongliaInner MongliaChina Department of Neurology The First People’s Hospital of ShenyangShenyangChina Neurology Beijing Tiantan HospitalBeijingChina

Background Tenecteplase(TNK)possesses several pharmacological characteristics superior to conventional alteplase(rt-PA),with well-established safety and efficacy profile in Caucasians.There exists controversy over the optimal dose of intravenous rt-PA for East Asians with acute ischaemic stroke(AIS).Current study aimed to determine the safety dose range of recombinant human TNK tissue-type plasminogen activator(rhTNK-tPA)for patients with AIS in China.Methods This multicentre,prospective,randomised,open-label,blinded end-point,phase II study compared three tiers of 0.1,0.25,0.32 mg/kg rhTNK-tPA(to a maximum of 40 mg)with standard 0.9 mg/kg rt-PA(to a maximum of 90 mg)in patients who were eligible for intravenous thrombolysis.The safety outcome were symptomatic intracranial haemorrhage(sICH)within 36 hours.Results Between May 2018 and February 2020,240 patients were randomly assigned to four group,4 of whom did not receive study treatment.The intention-to-treat analysis included 236 patients.There was no difference in the improvement on National Institutes of Health Stroke Scale at day 14 in the 3 tiers and control group(63.3%,77.2%,66.7%vs 62.7%).The number of sICH was 3 of 60(5.0%)in the 0.1 mg/kg group,none in the 0.25 mg/kg group,2 of 60(3.3%)in the 0.32 mg/kg group and 1(1.7%)of 59 in the rt-PA group.There were no significant between-group differences in severe adverse events.Conclusions Similar to the Caucasians,rhTNK-tPA was well tolerated in Chinese patients with AIS at all doses administered within 3 hours of symptom onset.The dose-efficacy profile of rhTNK-tPA needs to be established with future investigations.

关键词： patients doses centre

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Association between cumulative exposure to different lipid parameters and risk of newly developed carotid plaque

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Stroke & Vascular Neurology 2021年第3期6卷 359-365页

作者： Jianwei Wu Yu Wang Kaijiang Kang Anxin Wang Jie Xu xingquan zhao Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases BeijingChina Center of Stroke Beijing Institute for Brain DisordersBeijingChina Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease BeijingChina Department of Epidemiology and Health Statistics School of Public HealthCapital Medical UniversityBeijingChina Beijing Municipal Key Laboratory of Clinical Epidemiology BeijingChina

Background and purpose Both the magnitude and cumulative exposure of atherogenic lipoproteins have an impact on the atherosclerosis risk,and the exploration focus has shifted from one single lipoprotein assessment to the cumulative exposure of lipoproteins.We aim to investigate the relationship between cumulative exposure to different lipid parameters and the risk of newly developed carotid plaque in this study.Methods In the Asymptomatic Polyvascular Abnormalities Community study,2947 participants were included with follow-up every 2 years from 2006 to 2012.Lipid parameters including total cholesterol(TC),triglycerides(TGs),low-density lipoprotein cholesterol(LDLC),high-density lipoprotein cholesterol(HDLC)and non-HDLC were measured.Cumulative exposure was calculated by adding the weighted sum of the difference between the measured value and the cut-off value of each parameter.Newly developed carotid plaques were identified by carotid ultrasound performed at the third and fourth follow-ups.Results In the univariate analysis,non-HDLC burden had the highest ORs among the five lipid parameters for newly developed carotid plaque in each quartile,as 1.0(reference),1.35(1.09-1.67),1.68(1.36-2.08)and 2.74(2.22-3.38)from the lowest to the highest quartile.In the multivariate analysis and sensitivity analysis,we obtained similar results.Conclusions TC burden,TG burden,LDLC burden and non-HDLC burden are all independent risk factors for newly developed carotid plaque,especially for the vulnerable plaques.Among lipid parameters,non-HDLC burden is an optimal predictor.Moreover,the predictive value remained significant for participants under the age of 65 years old or free of hypertension,diabetes mellitus and hyperlipidaemia.

关键词： carotid Lipid cholesterol

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高水平空腹血糖与缺血性卒中患者静脉溶栓后功能结局的关系分析

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中国卒中杂志 2024年第3期19卷 293-298页

作者：丁则昱李光硕赵性泉首都医科大学附属北京天坛医院神经病学中心北京100070 国家神经系统疾病临床医学研究中心

目的探讨空腹血糖与接受静脉溶栓的缺血性卒中患者功能结局的关系。方法回顾性收集2018年10月—2020年11月首都医科大学附属北京天坛医院静脉溶栓患者的病历资料。纳入发病4.5 h内接受阿替普酶静脉溶栓的缺血性卒中患者为研究对象,采集... 详细信息

目的探讨空腹血糖与接受静脉溶栓的缺血性卒中患者功能结局的关系。方法回顾性收集2018年10月—2020年11月首都医科大学附属北京天坛医院静脉溶栓患者的病历资料。纳入发病4.5 h内接受阿替普酶静脉溶栓的缺血性卒中患者为研究对象,采集相关研究数据(包括空腹血糖等)。研究结局设定为出院时功能结局良好,即mRS评分0~1分。采用多因素logistic回归分析探讨空腹血糖与功能结局的关联性。结果共入组205例患者,平均年龄为(63.21±11.67)岁,其中153例(74.63%)患者为男性,入院NIHSS评分为5(3~9)分。其中117例(57.07%)患者出院时功能结局不良,88例(42.93%)患者出院时功能结局良好。功能结局良好的患者空腹血糖水平低于功能结局不良的患者[5.10(4.46~7.06)mmol/L vs.6.33(5.09~7.79)mmol/L,P=0.001]。多因素logistic回归分析结果显示,校正年龄、性别、NIHSS评分后,空腹血糖水平与接受静脉溶栓功能结局相关(OR0.876,95%CI0.774~0.991,P=0.035);校正年龄、性别、NIHSS评分、桥接取栓后,关联性没有达到统计学意义(OR0.891,95%CI0.791~1.004,P=0.058)。结论对于接受静脉溶栓的缺血性卒中患者,高水平空腹血糖可能会增加静脉溶栓后出院功能结局不良风险。

关键词：缺血性卒中静脉溶栓空腹血糖功能预后

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Rationale and design of a randomised double-blind 2×2 factorial trial comparing the effect of a 3-month intensive statin and antiplatelet therapy for patients with acute mild ischaemic stroke or high-risk TIA with intracranial or extracranial atherosclerosis(INSPIRES)

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Stroke & Vascular Neurology 2023年第3期8卷 249-258,I0096-I0110页

作者： Ying Gao Yuesong Pan Shangrong Han Weiqi Chen Jing Jing Chunjuan Wang Yingying Yang Tingting Wang Xia Meng xingquan zhao Liping Liu Hao Li S Claiborne Johnston Pierre Amarenco Philip M Bath Yongjun Wang Yilong Wang Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Dean's Office Dell Medical SchoolUniversity of Texas at AustinAustinTexasUSA Department of Neurology and Stroke Center Assistance Publique-Hôpitaux de Paris(APHP)Bichat HospitalINSERM LVTS-U1148University of ParisParisFrance Population Health Research Institute McMaster UniversityHamiltonOntarioCanada Stroke Trials Unit Mental Health&Clinical NeuroscienceUniversity of NottinghamNottinghamUK Advanced Innovation Center for Human Brain Protection Capital Medical UniversityBeijingChina National Center for Neurological Diseases BeijingChina Research Unit of Artificial Intelligence in Cerebrovascular Disease Chinese Academy of Medical SciencesBeijingChina Chinese Institute for Brain Research BeijingChina

Background It remains unclear if intensive antiplatelet and statin treatments begun within 24-72 hours of cerebral ischaemic events from intracranial or extracranial atherosclerosis is effective or safe.Methods The Intensive Statin and Antiplatelet Therapy for High-risk Intracranial or Extracranial Atherosclerosis(INSPIRES)trial is a randomised,double-blind,placebo-controlled,multicentre and 2×2 factorial trial.6100 individuals between the ages of 35 and 80 who have experienced a mild ischaemic stroke or high-risk transient ischaemic attack(TIA)within the previous 72 hours that is attributed to≥50%atherosclerotic stenosis of a major intracranial or extracranial artery or multiple infarctions of atherosclerotic origin will be enrolled in the trial.Eligible subjects will be randomised 1:1:1:1 to one of four groups:(1)intensive antiplatelet therapy(combined clopidogrel and aspirin for days 1-21,then aspirin placebo and clopidogrel for days 22-90)plus immediate intensive statin therapy(atorvastatin at a dose of 80 mg daily for the first 21 days,then 40 mg daily for days 22-90);(2)intensive antiplatelet therapy plus delayed intensive statin therapy(atorvastatin placebo for days 1-3,followed by 40 mg per day of atorvastatin for days 4-90);(3)standard antiplatelet therapy(combination of clopidogrel placebo with aspirin for 90 days)plus immediate intensive statin therapy and(4)standard antiplatelet therapy plus delayed intensive statin therapy.The primary efficacy endpoint is any new stroke(ischaemic or haemorrhagic)within 90 days after randomisation.The primary safety endpoint is moderate to severe bleeding at 90 days.Conclusion The INSPIRES trial will assess the efficacy and safety of intensive antiplatelet therapy and immediate intensive statin therapy begun within 72 hours of onset in decreasing the recurrent stroke at 90 days in patients with acute mild ischaemic stroke or high-risk TIA of intracranial or extracranial atherosclerosis origin.

关键词： intracranial atherosclerosis random

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