Safety and Efficacy of Early Antiplatelet Treatment With Aspirin After Intravenous Thrombolysis for Acute Ischemic Stroke: A Multicenter, Randomized, Placebo-Controlled Clinical Trial
Led by Capital Medical University · Updated on 2025-12-19
1184
Participants Needed
71
Research Sites
N/A
Total Duration
On this page
AI-Summary
Brief Title
Who Can Participate
AI-Screening
Your Study Journey
Trial Site Locations
Research Team
How is the study designed?
Similar Trials
Frequently Asked Questions
Research Publications
AI-Summary
What this Trial Is About
Acute ischemic stroke is a leading cause of death worldwide, and intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) within 4.5 hours of symptom onset is the most effective treatment currently available. However, some patients experience stroke progression and early reocclusion after thrombolysis, which can worsen neurological outcomes. This trial evaluates whether early antiplatelet therapy with oral aspirin, given soon after thrombolysis, can improve recovery without increasing bleeding risks.
The study randomly assigns patients to receive either early oral aspirin within 3 hours of starting intravenous thrombolysis or a placebo, alongside the best medical care based on current guidelines. Aspirin is administered as a 300 mg dose, either chewed or given via nasogastric tube if swallowing is difficult. The trial includes a control group receiving placebo under similar conditions to compare outcomes. This is a Phase 3, multicenter, quadruple-blind, randomized clinical trial.
During the study, participants will be closely monitored for neurological status and functional recovery using the modified Rankin scale at 30 and 90 days after stroke, as well as other assessments like NIH Stroke Scale scores within the first week. Researchers will track early neurological changes and safety outcomes such as intracranial hemorrhage. Follow-up will include evaluations at multiple time points up to 90 days post-stroke to determine the effects of early antiplatelet treatment on stroke recovery.
CONDITIONS
Brief Title
Early Antiplatelet Administration After Intravenous Thrombolysis for Acute Ischemic Stroke (TREND-IVT)
Who Can Participate
Age: 18Years +
All Genders
Eligibility Criteria
You may qualify if you...
Age 18 years or older
Acute ischemic stroke treated with intravenous thrombolysis (alteplase or tenecteplase) within 4.5 hours of symptom onset or last known well
Able to receive study drug within 3 hours of starting intravenous thrombolysis
Residual NIH Stroke Scale score greater than 5 points one hour after thrombolysis and before randomization
Informed consent obtained from patient or authorized representative
You will not qualify if you...
Stroke caused by definite large vessel occlusion confirmed by vessel imaging or scheduled for endovascular treatment
Intracranial hemorrhage confirmed by imaging after thrombolysis
Definite or suspected cardioembolic stroke
Stroke caused by other determined causes such as moyamoya disease, artery dissection, arteritis, hypercoagulable states, or hematological disorders
Use of antiplatelet therapy within one week before stroke onset or certain anticoagulants within 48 hours before stroke onset
Prior moderate or severe ischemic stroke with residual disability
Pre-stroke modified Rankin scale score greater than 1
Severe consciousness disturbance (NIHSS item 1a score 2 or higher)
Post-thrombolysis infarct larger than half the artery supply area
Known contraindications to antiplatelet therapy, including coagulation disorders or systemic bleeding
History of aspirin allergy
Anticipated need for anticoagulant therapy during the study period
Presence of malignant tumors, chronic hemodialysis, severe kidney or liver insufficiency, or severe heart failure
Severe non-cardiovascular complications with expected survival under 6 months
Unavailability for follow-up
Presence of dementia, psychiatric, or neurological conditions complicating follow-up
Current participation in another therapeutic study with ongoing treatment and follow-up
Other conditions making participation unsuitable as determined by the investigator
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - Up to 7 days after stroke
Participants receive early antiplatelet treatment with oral aspirin or placebo within 3 hours of starting intravenous thrombolysis, alongside best medical management according to guidelines.
Multiple visits within 7 days for neurological assessments
Follow-up
Duration - Up to 90 days after stroke
Participants are followed up to assess recovery and neurological outcomes after treatment.
Visits at 30 days and 90 days
Trial Site Locations
Total: 71 locations
1
The Third The People's Hospital Of Bengbu
Bengbu, Anhui, China, 233000
Actively Recruiting
2
Suzhou municipal hospital
Suzhou, Anhui, China, 234000
Actively Recruiting
3
Xuanwu Hospital, Capital Medical University
Beijing, Beijing Municipality, China, 100053
Actively Recruiting
4
Aerospace central hospital
Haidian, Beijing Municipality, China, 100049
Actively Recruiting
5
Beijing Pinggu District Hospital
Pinggu, Beijing Municipality, China, 101200
Actively Recruiting
6
Beijing Luhe Hospital affiliated to Capital Medical University
Tongzhou, Beijing Municipality, China, 101149
Actively Recruiting
7
Fujian university affiliated provincial hospital
Fuzhou, Fujian, China, 350001
Actively Recruiting
8
The First Affiliated Hospital Of Xiamen University
Xiamen, Fujian, China, 361003
Actively Recruiting
9
Xiamen Xinglin hospital
Xiamen, Fujian, China, 361020
Not Yet Recruiting
10
Zhangzhou Hospital of Fujian Province
Zhangzhou, Fujian, China, 363000
Actively Recruiting
11
Brain Hospital Affiliated to Guangzhou Medical University
Guangzhou, Guangdong, China, 510180
Not Yet Recruiting
12
Guigang people's hospitalv
Guigang, Guangxi, China, 537100
Actively Recruiting
13
Wuzhou Red Cross Hospital
Wuzhou, Guangxi, China, 543002
Actively Recruiting
14
The Second Affiliated Hospital of Guizhou Medical University
Kaili, Guizhou, China, 556099
Actively Recruiting
15
The Second Affiliated Hospital of Hainan Medical University
Haikou, Hainan, China, 570145
Actively Recruiting
16
Cangzhou combination of Chinese traditional and western medicine hospital
Cangzhou, Hebei, China, 061001
Actively Recruiting
17
Cangzhou Central Hospital
Cangzhou, Hebei, China, 061012
Actively Recruiting
18
Hejian city People's Hospital
Cangzhou, Hebei, China, 062450
Actively Recruiting
19
Handan Central Hospital
Handan, Hebei, China, 056001
Actively Recruiting
20
Handan first hospital
Handan, Hebei, China, 056002
Actively Recruiting
21
The First Hospital Of Qiqihar
Qiqihar, Heilongjiang, China, 161005
Actively Recruiting
22
Hua county People's Hospital
Anyang, Henan, China, 456400
Actively Recruiting
23
Jun county people's hospital
Hebi, Henan, China, 458030
Actively Recruiting
24
Jiaozuo Second People's Hospital
Jiangzuo, Henan, China, 454001
Actively Recruiting
25
First People's Hospital of Luoyang
Luoyang, Henan, China, 471000
Actively Recruiting
26
Luoyang Yanshi People's Hospital
Luoyang, Henan, China, 471900
Actively Recruiting
27
Nanyang nanshi hospital
Nanyang, Henan, China, 473010
Not Yet Recruiting
28
Huanghe Sanmenxia hospital
Sanmenxia, Henan, China, 472000
Not Yet Recruiting
29
Shangqiu Third People's Hospital
Shangqiu, Henan, China, 476000
Actively Recruiting
30
Shangqiu First People's Hospital
Shangqiu, Henan, China, 476100
Actively Recruiting
31
Ningling county people's hospital
Shangqucun, Henan, China, 476700
Actively Recruiting
32
Xihua People's Hospital
Zhoukou, Henan, China, 466000
Actively Recruiting
33
Luyi county people's hospital
Zhoukou, Henan, China, 477200
Actively Recruiting
34
Zhumadian Central Hospital
Zhumadian, Henan, China, 463000
Actively Recruiting
35
The Third People's Hospital of Hubei Province
Hainan, Hubei, China, 430033
Actively Recruiting
36
The First People's Hospital of Changde City
Changde, Hunan, China, 415000
Actively Recruiting
37
Changde Taoyuan County People's Hospital
Changde, Hunan, China, 415099
Not Yet Recruiting
38
Chenzhou first people's hospital
Chenzhou, Hunan, China, 424499
Not Yet Recruiting
39
Liuyang Jili Hospital
Guankou, Hunan, China, 410300
Actively Recruiting
40
Xiangtan Central Hospital
Xiangtan, Hunan, China, 411100
Actively Recruiting
41
Zhuzhou Central Hospital
Zhuzhou, Hunan, China, 412007
Actively Recruiting
42
Affiliated Hospital of Inner Mongolia University for the Nationalities
Tongliao, Inner Mongolia, China, 028007
Actively Recruiting
43
Ulanqab Central Hospital
Ulanqab, Inner Mongolia, China, 012000
Actively Recruiting
44
Zha Lan Tun Shi Zhong Meng Yi Yuan
Zhalantun, Inner Mongolia, China, 162650
Actively Recruiting
45
The First Affiliated Hospital of Soochow University
Suzhou, Jiangsu, China, 215004
Actively Recruiting
46
The Fourth Affiliated Hospital of Soochow University
Suzhou, Jiangsu, China, 215021
Actively Recruiting
47
Jingdezhen NO.1 People's Hospital
Jingdezhen, Jiangxi, China, 333000
Actively Recruiting
48
The Second Affiliated Hospital Of Nanchang University
Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.
William J Powers, Alejandro A Rabinstein, Teri Ackerson...
Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.
Bart M Demaerschalk, Dawn O Kleindorfer, Opeolu M Adeoye...
Safety and Efficacy of Early Aspirin Administration After Intravenous Thrombolysis for Acute Ischemic Stroke (TREND-IVT): Rationale and Design of a Multicenter, Randomized, Placebo-Controlled Clinical Trial.