BACKGROUND Argatroban in acute noncardioembolic stroke ineligible for intravenous thrombolysis (IVT) or endovascular treatment (EVT) remains unclear. This study aimed to evaluate whether argatroban improved early and long-term outcomes compared with antiplatelet treatment. METHODS This retrospective observational study, using the prospective stroke database from our hospital, included all consecutive patients who hospitalized from January 1, 2017 to December 31, 2019, with a diagnosis of acute non-cardioembolic stroke within 48 hours of stroke onset but not receiving IVT and EVT. Patients were divided into 2 groups: the argatroban group and the control group without argatroban. Outcome assessment with early neurological deterioration (END), National Institutes of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), bleeding complications, and mortality were compared between the 2 groups in all cases and different stroke subtypes. An ordinal logistic regression analysis evaluated the association between argatroban use and mRS score at 90 days. RESULTS Of 1325 patients were enrolled, 519 patients in the argatroban group and 806 in the control. Baseline characteristics, hospital bleeding complications, and 90-day mortality were similar for the 2 groups. The argatroban group showed lower END, larger improvement of 7-day NIHSS score and higher percentage of a 90-day mRS score of 02. Similar results were found in subgroup analysis with large-artery atherosclerosis, anterior circulation infarction, and moderate stroke. Also, argatroban use was significantly associated with an excellent long-term stroke outcome (mRS ≤ 2). CONCLUSION The current study suggested that argatroban was safe and effective for improving short and long-term outcomes in noncardioembolic stroke patients.

中文翻译：

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急性非心源性卒中患者使用阿加曲班的长期结果

背景 阿加曲班在不适合静脉溶栓 (IVT) 或血管内治疗 (EVT) 的急性非心源性卒中中的应用仍不清楚。本研究旨在评估与抗血小板治疗相比，阿加曲班是否能改善早期和长期结果。方法 本项回顾性观察性研究使用我院的前瞻性卒中数据库，纳入了 2017 年 1 月 1 日至 2019 年 12 月 31 日住院、在卒中发病 48 小时内诊断为急性非心源性卒中但未接受治疗的所有连续患者。 IVT 和 EVT。患者分为2组：阿加曲班组和不含阿加曲班的对照组。早期神经功能恶化 (END)、美国国立卫生研究院卒中量表 (NIHSS)、改良 Rankin 量表 (mRS)、出血并发症、比较两组所有病例和不同脑卒中亚型的死亡率和死亡率。有序逻辑回归分析评估了阿加曲班使用与 90 天时 mRS 评分之间的关​​联。结果 共纳入 1325 名患者，阿加曲班组 519 名，对照组 806 名。两组的基线特征、医院出血并发症和 90 天死亡率相似。阿加曲班组的 END 较低，7 天 NIHSS 评分改善幅度较大，90 天 mRS 评分为 02 的百分比较高。在大动脉粥样硬化、前循环梗塞和中度卒中的亚组分析中也发现了类似的结果。此外，阿加曲班的使用与良好的长期卒中结局（mRS ≤ 2）显着相关。