{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:45:02Z","timestamp":1782992702097,"version":"3.54.5"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Intravenous thrombolysis followed by endovascular thrombectomy (EVT) is a first\u2010line recommended strategy for thrombolysis\u2010eligible patients with stroke due to acute large\u2010vessel occlusion. Tirofiban, one of the most used glycoprotein IIb\/IIIa receptor inhibitors, has been increasingly advocated to counteract different stages of thrombosis mediated by activated platelets. It is unclear whether tirofiban could be used as an alternative to thrombolysis as adjuvant medicine for EVT. This trial aims to assess whether intravenous tirofiban plus EVT is noninferior to intravenous thrombolysis bridging with EVT in patients with acute ischemic stroke due to large\u2010vessel occlusion who are eligible for thrombolysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">ADJUVANT (Intravenous Tirofiban Versus Thrombolysis Before Endovascular Stroke Thrombectomy) is an investigator\u2010initiated, multicenter, randomized, open\u2010label, noninferiority trial with blinded end point assessment conducted at 42 thrombectomy\u2010capable centers in China. This trial will randomize 976 thrombolysis\u2010eligible stroke patients with confirmed occlusion of the internal carotid artery, M1\/M2 segments of the middle cerebral artery, or basilar artery in a 2:1 ratio to receive intravenous tirofiban plus EVT or intravenous thrombolysis bridging with EVT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">The primary efficacy outcome is functional independence, defined as a score of 0 to 2 on the modified Rankin scale, at 90\u2009days. Safety outcomes are symptomatic intracranial hemorrhage within 48\u2009hours and death within 90\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">ADJUVANT will provide unique information about the efficacy and safety of adjuvant intravenous tirofiban before EVT in thrombolysis\u2010eligible patients with stroke due to acute large\u2010vessel occlusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">https:\/\/clinicaltrials.gov<\/jats:ext-link>\n                      . Unique Identifier: NCT05728333.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045967","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T12:45:08Z","timestamp":1772628308000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["ADJUVANT Randomized Controlled Trial: Rationale and Design"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6156-0392","authenticated-orcid":false,"given":"Hongfei","family":"Sang","sequence":"first","affiliation":[{"name":"Westlake University School of Medicine","place":["Hangzhou, China"]},{"name":"Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8982-2766","authenticated-orcid":false,"given":"Zhilin","family":"Zheng","sequence":"additional","affiliation":[{"name":"Westlake University 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