Why the study?
Minor ischemic stroke can cause significant disability, but treatment choice remains uncertain given the bleeding risks of r-tPA and the potentially lower efficacy of aspirin.
Does intravenous r-tPA improve outcomes compared to aspirin in patients with acute minor ischemic stroke?
Does intravenous r-tPA improve outcomes compared to aspirin in patients with acute minor ischemic stroke?
Aspirin and intravenous r-tPA appear to yield similar clinical outcomes in the treatment of acute minor ischemic stroke.
Supports aspirin as initial therapy for acute minor ischemic stroke; extends RCT evidence of equivalence to r-tPA.
OBJECTIVES: Minor ischemic stroke is common and may lead to significant disability, even when symptoms appear mild or are poorly tolerated. Treatment choice remains uncertain: Recombinant Tissue Plasminogen Activator (r-tPA) may aid recovery but carries bleeding risk, while aspirin is safer but possibly less effective. This meta-analysis compares aspirin and intravenous r-tPA in this population. METHODS: statistic. Subgroup analyses restricted to RCTs and leave-one-out sensitivity analyses yielded consistent results across all outcomes. DISCUSSION: Both aspirin and r-tPA were associated with clinical benefit and yielded similar outcomes in minor strokes.
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Fernandes et al. (2025) studied this question.
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