{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:20:59Z","timestamp":1792797659433,"version":"4.5.0"},"reference-count":26,"publisher":"BMJ","issue":"4","funder":[{"name":"Science and Technology Project Plan of Liao Ning Province"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Stroke Vasc Neurol"],"accepted":{"date-parts":[[2018,8,31]]},"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A recent study shows that dual antiplatelet therapy with clopidogrel plus aspirin is superior to aspirin monotherapy for minor stroke, which is defined as a National Institutes of Health Stroke Scale (NIHSS)score of \u22643. However, acute mild-moderate ischaemic stroke (4\u2264NIHSS\u226410) still needs aggressive antiplatelet intervention to prevent deterioration and recurrence of stroke. The efficacy and safety of dual antiplatelet therapy versus aspirin monotherapy in the population are not clear. A multicentre clinical trial is designed to evaluate the efficacy and safety of clopidogrel plus aspirin therapy versus aspirin monotherapy within 48\u2009hours of symptom onset of mild-moderate ischaemic stroke.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods\/Design<\/jats:title>\n                  <jats:p>The study is a randomised, open-label, multicentre, prospective trial with a target enrolment of 2700 patients from 60 centres in Northeast China. A treatment allocation identification number to each enrolled patient will be provided by a random number generator. The follow-up time for the clopidogrel plus aspirin and aspirin monotherapy groups is 90 days. The primary efficacy endpoint is a stroke progression event, which is defined as \u22654\u2009point increase in the NIHSS score in 48\u2009hours. The second efficacy endpoints include new ischaemic stroke within 90 days, change in the NIHSS score within 14\u2009days, modified Rankin Scale score on day 90 and other vascular or death events within 90 days. The safety endpoints include mucocutaneous haemorrhage, organ haemorrhage and intracranial haemorrhage, adverse events and severe adverse events. \u03c7<jats:sup>2<\/jats:sup> test, t-test (or Mann-Whitney test), survival analysis and Cox proportional hazards models will be conducted. The findings of the study may provide an important evidence for clinical practice for these patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The trial will be conducted under a rational design and will provide valuable evidence on the appropriate treatment for this population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>The study was reviewed and approved by the Ethics Committee of the General Hospital of Shen-Yang Military Region (no K(2016) 6).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT02869009\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial pre-results\">NCT02869009<\/jats:ext-link>; Pre-results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/svn-2018-000148","type":"journal-article","created":{"date-parts":[[2018,9,23]],"date-time":"2018-09-23T23:55:15Z","timestamp":1537746915000},"page":"263-267","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Antiplatelet Therapy in Acute Mild-Moderate Ischemic Stroke (ATAMIS): a parallel, randomised, open-label, multicentre, prospective study"],"prefix":"10.1136","volume":"3","clinical-trial-number":[{"clinical-trial-number":"nct02869009","registry":"10.18810\/clinical-trials-gov","type":"preResults"},{"clinical-trial-number":"nct02869009","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Xiaowen","family":"Hou","sequence":"first","affiliation":[{"name":"Department of Neurology, General Hospital of Shen-Yang Military Region, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqiu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, General Hospital of Shen-Yang Military Region, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinhong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, General Hospital of Shen-Yang Military Region, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8490-9435","authenticated-orcid":false,"given":"Huisheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, General Hospital of Shen-Yang Military Region, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,9,23]]},"reference":[{"key":"2025081709452608000_3.4.263.1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd000213"},{"key":"2025081709452608000_3.4.263.2","first-page":"CD000029","article-title":"Antiplatelet therapy for acute ischaemic stroke","volume":"2","author":"Sandercock","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"2025081709452608000_3.4.263.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0804656"},{"key":"2025081709452608000_3.4.263.4","first-page":"1230","article-title":"Thrombolysis treatment of acute ischemic stroke","volume":"16","author":"Lu","year":"2014","journal-title":"Chin J Geriatr Heart Brain Vessel [Chinese]"},{"key":"2025081709452608000_3.4.263.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)04011-7"},{"key":"2025081709452608000_3.4.263.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)04010-5"},{"key":"2025081709452608000_3.4.263.7","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000158"},{"key":"2025081709452608000_3.4.263.8","first-page":"246","article-title":"Guidelines for the diagnosis and treatment of acute ischemic stroke in China 2014","volume":"48","author":"Neurology branch of Chinese Medical Association","year":"2015","journal-title":"Chin J Neurol [Chinese]"},{"key":"2025081709452608000_3.4.263.9","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70060-0"},{"key":"2025081709452608000_3.4.263.10","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.003038"},{"key":"2025081709452608000_3.4.263.11","first-page":"CD005158","article-title":"Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular disease","volume":"3","author":"Keller","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"2025081709452608000_3.4.263.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1215340"},{"key":"2025081709452608000_3.4.263.13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800410"},{"key":"2025081709452608000_3.4.263.14","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"2025081709452608000_3.4.263.15","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1111\/ene.12982","article-title":"Dual antiplatelet therapy after stroke or transient ischaemic attack - how long to treat? 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