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Early Low-dose ASpirin Use After Intravenous Thrombolysis for Acute Ischemic Cerebral Infarction（ELASTIC） (ELASTIC)

5. maj 2026 opdateret af: Beijing Chao Yang Hospital

Safety and Efficacy of Treatment With Early Low-dose ASpirin Use After Intravenous Thrombolysis for Acute Ischemic Cerebral Infarction (ELASTIC): A Randomized, Open-label, Blinded Endpoint, Clinical Trial

This study evaluates whether early administration of low-dose aspirin (100mg) at 2 hours post-intravenous thrombolysis, compared to the standard timing of 24 hours, improves functional outcomes in patients with acute ischemic stroke. Intravenous thrombolysis is effective for very early treatment of acute ischemic stroke. However, current guidelines recommend starting antiplatelet therapy 24 hours after thrombolysis to avoid symptomatic intracranial hemorrhage (SICH), a recommendation not based on prospective clinical studies. Early re-occlusion of recanalized arteries due to platelet aggregation occurs in 14-34% of cases and is associated with poor prognosis. The average incidence of SICH is 2.4%, with fatal SICH occurring in only 0.28%. Thus, the impact of re-occlusion on poor prognosis may outweigh the risk of SICH. In this prospective, randomized, open-label trial with blinded endpoint evaluation, participants are assigned to receive aspirin 100mg either at 2 hours (early group) or at 24 hours (standard group) after thrombolysis. The primary outcome is the proportion of patients with a favorable functional outcome, defined as a modified Rankin Scale (mRS) score of 0-2 at 3 months. Safety outcomes include the incidence of SICH and all-cause mortality at 3 months. This study will provide clinical evidence regarding the optimal timing for initiating antiplatelet therapy after thrombolysis in acute ischemic stroke.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

210

Fase

  • Fase 4

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Kina
    • Beijing Municipality
      • Beijing, Beijing Municipality, Kina, 100020
        • Beijng Chao-Yang Hospital, Capital Medical University

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  1. Age range: 18-65 years old
  2. Receive rt PA thrombolytic therapy within 3 hours (including 3 hours) of onset
  3. Signs of brain dysfunction lasting for more than 1 hour
  4. CT imaging excludes cerebral hemorrhage, and there are no imaging changes corresponding to the patient's physical signs

Exclusion Criteria:

  1. Age>65 years old
  2. Onset time>3 hours
  3. Accompanied by consciousness disorders, or NIHSS ≥ 20 points
  4. CT shows' high-density shadow of middle cerebral artery '
  5. Accompanied by atrial fibrillation or clearly identified as cardioembolic embolism
  6. Severe swallowing difficulties, unable to take medication orally
  7. Oral anticoagulant medication is currently being taken
  8. Accompanied by severe infection or evidence of severe infection
  9. Refusal to sign the informed consent form for this study
  10. Exclusion criteria for other traditional intravenous thrombolysis

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Early Aspirin Group
Participants receive oral aspirin 100mg at 2 hours after rt-PA thrombolysis. A follow-up CT scan is performed at 2 hours post-thrombolysis. If no intracranial hemorrhage is confirmed, aspirin 100mg once daily (Qd) is continued for 3 months.
Medicin: Aspirin (Early, 2h)
Aspirin 100mg orally, administered once daily. The first dose is given at 2 hours after rt-PA thrombolysis, conditional on a follow-up CT scan at 2 hours excluding intracranial hemorrhage. Treatment continues for 3 months.
Aktiv komparator: Standard Therapy Group
Participants receive oral aspirin 100mg once daily (Qd) starting at 24 hours after rt-PA thrombolysis. A follow-up CT scan is performed at 24 hours post-thrombolysis. If no intracranial hemorrhage is confirmed, aspirin 100mg once daily (Qd) is continued for 3 months.
Medicin: Aspirin (Standard, 24h)
Aspirin 100mg orally, administered once daily. The first dose is given at 24 hours after rt-PA thrombolysis, conditional on a follow-up CT scan at 24 hours confirming no intracranial hemorrhage. Treatment continues for 3 months.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Proportion of Patients with Favorable Functional Outcome at 3 Months
Tidsramme: 3 months
Favorable functional outcome is defined as a score of 0 to 2 on the modified Rankin Scale (mRS). The mRS score will be assessed by a blinded endpoint assessor at 3 months post-stroke via a structured telephone interview or during a clinic visit.
3 months

Sekundære resultatmål

Resultatmål
Tidsramme
Incidence of symptomatic intracranial hemorrhage
Tidsramme: 24 hour
24 hour
Patient mortality rate at 3 months
Tidsramme: 3 months
3 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Beijing Chao Yang Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. maj 2026

Primær færdiggørelse (Anslået)

30. september 2027

Studieafslutning (Anslået)

31. december 2027

Datoer for studieregistrering

Først indsendt

26. april 2026

Først indsendt, der opfyldte QC-kriterier

26. april 2026

Først opslået (Faktiske)

4. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

8. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

5. maj 2026

Sidst verificeret

1. april 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • Beijing CYH

Plan for individuelle deltagerdata (IPD)

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UBESLUTET

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