研究单位：[1]Capital Medical University[2]The Third The People's Hospital Of Bengbu,Bengbu,Anhui,China,233000[3]Xuanwu Hospital, Capital Medical University,Beijing,Beijing,China,100053[4]The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College,Chongqing,Chongqing,China,401121[5]The First Affiliated Hospital Of Xiamen University,Xiamen,Fujian,China,361003[6]The Second People's Hospital Of Qinzhou,Qinzhou,Guangxi,China,535099[7]Wuzhou Red Cross Hospital,Wuzhou,Guangxi,China,543002[8]The First Hospital Of Qiqihar,Qiqihar,Heilongjiang,China,161005[9]Luoyang Yanshi People's Hospital,Luoyang,Henan,China,471900[10]Xihua People's Hospital,Zhoukou,Henan,China,466000[11]Liuyang Jili Hospital,Liuyang,Hunan,China,410300[12]Xiangtan Central Hospital,Xiangtan,Hunan,China,411100[13]Zhuzhou Central Hospital,Zhuzhou,Hunan,China,412007[14]Affiliated Hospital of Inner Mongolia University for the Nationalities,Tongliao,Inner Mongolia,China,028007[15]Ulanqab Central Hospital,Ulanqab,Inner Mongolia,China,012000[16]Zha Lan Tun Shi Zhong Meng Yi Yuan,Zhalantun,Inner Mongolia,China,162650[17]Jingdezhen NO.1 People's Hospital,Jingdezhen,Jiangxi,China,333000[18]The Second Affiliated Hospital Of Nanchang University,Nanchang,Jiangxi,China,330008[19]Jinan Third People's Hospital,Jinan,Shandong,China,250101[20]The Third People Hospital In Liaocheng,Liaocheng,Shandong,China,252000[21]Weihai Municipal Hospital,Weihai,Shandong,China,264200[22]The People's Hospital Of Leshan,Leshan,Sichuan,China,614000[23]Shihezi City People's Hospital,Shihezi,Xinjiang,China,832000[24]Haiyan People's Hospital,Jiaxing,Zhejiang,China,314311
Stroke is the second leading cause of death worldwide, and ischemic stroke is the most frequent type. Intravenous thrombolysis with recombinant tissue plasminogen activator within 4.5 hours of symptom onset is the most effective therapy for patients with acute ischemic stroke. However, ischemic stroke progression and early reocclusion are not an uncommon phenomenon in patients after intravenous thrombolysis, resulting in neurological deterioration, which is associated with unfavorable functional outcomes. The underlying mechanism mainly involves the augmented platelet activation, triggered by the activated coagulation cascade during thrombolysis, which peaks within 2 hours of initiating rt-PA administration. Therefore, early antiplatelet therapy following intravenous thrombolysis represents a promising therapeutic approach to prevent neurological deterioration and improve the functional outcome of patients treated with intravenous thrombolysis. Currently, guidelines recommend initiating antiplatelet therapy 24 hours after intravenous thrombolysis due to the potential risk of increased bleeding. The safety and efficacy of early antiplatelet treatment following intravenous thrombolysis in patients with acute ischemic stroke remain clear. The study aims to test the hypothesis that in patients with acute ischemic stroke treated with intravenous thrombolysis, early administration of oral aspirin will improve functional outcomes without increasing the risk of intracranial hemorrhage.
