Efficacy and safety of argatroban in acute branch atheromatous disease: A retrospective observational study

To evaluate the efficacy and safety of argatroban combined with dual antiplatelet therapy (DAPT) for treating acute branch atheromatous disease-related cerebral infarction.

A retrospective study was conducted of 127 stroke patients admitted to the Department of Neurology at the First Affiliated Hospital of Xinxiang Medical University from January 2022 to December 2023. Patients were divided into two groups: the argatroban group with 44 individuals (who initially received argatroban therapy and subsequently received DAPT) and the DAPT group with 83 individuals (who received treatment with aspirin combined with clopidogrel). Therapeutic effects were evaluated using the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale, and Activities of Daily Living scores before and after treatment.

After propensity score matching, 37 patients were included per group. The argatroban group showed higher rates of “basic cure,” 3-month modified Rankin Scale score ≤1, and NIHSS score reduction ≥2, and had a lower recurrence rate (p < 0.05). No adverse events were observed. Multivariate logistic regression confirmed a lower recurrence rate in the argatroban group. Subgroup analysis revealed better outcomes in older patients (higher NIHSS reduction ≥2) and in young/middle-aged patients with mild branch atheromatous disease (higher cure rate, lower incidence of early neurological deterioration) (p < 0.05).

Argatroban combined with DAPT in the acute phase improves cure rates, promotes neurological recovery, enhances short-term prognosis, reduces recurrence, and does not increase adverse reactions such as bleeding.