Background Whether to treat minor stroke with intravenous tissue plasminogen activator (t-PA) treatment or antiplatelet therapy is a dilemma. Our study aimed to explore whether intravenous t-PA treatment, dual antiplatelet therapy (DAPT) and aspirin have different efficacies on outcomes in patients with minor stroke. Methods A post hoc analysis of patients with acute minor stroke treated with intravenous t-PA within 4.5 hours from a nationwide multicentric electronic medical record and patients with acute minor stroke treated with DAPT and aspirin from the Clopidogrel with Aspirin in Acute Minor Stroke or Transient Ischemic Attack Database. Minor stroke was defined by a score of 0–3 on the National Institutes of Health Stroke Scale at randomisation. Favourable functional outcome (defined as modified Rankin Scale (mRS) score of 0–1 or 0–2 at 3 months). Results Compared with those treated with intravenous t-PA, no significant association with 3-month favourable functional outcome (defined as mRS score of 0–1) was found neither in patients treated with aspirin (87.8% vs 89.4%; OR, 0.83; 95% CI, 0.46 to 1.50; p=0.53) nor those treated with DAPT (87.4% vs 89.4%; OR, 0.84; 95% CI, 0.46 to 1.52; p=0.56). Similar results were observed for the favourable functional outcome defined as mRS score of 0–2 at 3 months. Conclusions In our study, no significant advantage of intravenous t-PA over DAPT or aspirin was found. Due to insufficient sample size, our study is probably unable to draw such a conclusion that that intravenous t-PA was superior or non-superior to DAPT. Data are available upon reasonable request. No additional data are available.

中文翻译：

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静脉内 t-PA、DAPT 或阿司匹林治疗急性轻度缺血性卒中患者预后的比较

背景 是用静脉组织纤溶酶原激活剂 (t-PA) 治疗还是抗血小板治疗来治疗轻微中风是一个难题。我们的研究旨在探讨静脉内 t-PA 治疗、双重抗血小板治疗 (DAPT) 和阿司匹林是否对轻度卒中患者的预后有不同的疗效。方法 对全国多中心电子病历中 4.5 小时内接受静脉 t-PA 治疗的急性轻度卒中患者和接受氯吡格雷联合阿司匹林的 DAPT 和阿司匹林治疗的急性轻度卒中或短暂性缺血性急性轻度卒中患者进行事后分析攻击数据库。轻度卒中定义为美国国立卫生研究院卒中量表随机评分为 0-3。良好的功能结果（定义为 3 个月时改良的 Rankin 量表 (mRS) 评分为 0-1 或 0-2）。结果 与接受静脉 t-PA 治疗的患者相比，接受阿司匹林治疗的患者与 3 个月的良好功能结果（定义为 mRS 评分为 0-1）均无显着相关性（87.8% vs 89.4%；OR，0.83； 95% CI，0.46 到 1.50；p=0.53）也不是那些用 DAPT 治疗的（87.4% 对 89.4%；OR，0.84；95% CI，0.46 到 1.52；p=0.56）。对于定义为 3 个月时 mRS 评分为 0-2 的有利功能结果，也观察到了类似的结果。结论 在我们的研究中，没有发现静脉内 t-PA 优于 DAPT 或阿司匹林的显着优势。由于样本量不足，我们的研究可能无法得出静脉 t-PA 优于或不优于 DAPT 的结论。可根据合理要求提供数据。没有额外的数据可用。