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Association Between Argatroban and Outcomes of Branch Atheromatous Disease: A Propensity-Matched Analysis From
Shengde Li1, Haizhou Hu1, Yaping Zhou1
1Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Background And Purpose:
Argatroban is widely used for patients with acute branch atheromatous disease (BAD)-related stroke, but its efficacy remains unclear. This study aims to evaluate its clinical outcomes in this patient population.
Methods:
A prospective, MRI-based cohort (BAD-study) was conducted across 20 hospitals in China from June 2021 to June 2023, enrolling patients aged 18-80 years with BAD-related stroke within 72 h of onset. Patients were divided into two groups: Argatroban and non-argatroban. The primary outcome was an excellent outcome, defined as a modified Rankin Scale (mRS) score of 0-1 at 90 days. Secondary outcomes included good outcome (mRS 0-2), mRS score, Barthel Index score at 90 days, and NIHSS score at 7 days. Logistic regression analyses were performed to assess the association between argatroban and outcomes after propensity score matching (PSM).
Results:
A total of 467 patients were included, with a median age of 60 years and a median NIHSS score of 4 at admission. Eighty-six patients (18.4%) were in the argatroban group, and 381 patients (81.6%) were in the non-argatroban group. After PSM, excellent outcomes occurred in 60.0% of the argatroban group and 64.2% of the non-argatroban group (odds ratio [OR] = 0.84, 95% CI: 0.47-1.49, p = 0.542). Argatroban was not significantly associated with secondary outcomes and remained ineffective in sensitivity analyses.
Conclusion:
Argatroban was not associated with excellent outcome at 90 days in patients with acute BAD-related stroke. Our study suggests that the risks and benefits of argatroban need reevaluation in patients with BAD-related stroke.
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