Tirzepatide in Thrombectomy-Treated Acute Ischemic Stroke: A Randomized Trial

Ki vehet részt

• Participants must meet all of the following criteria:
• Age >18 years and ≤80 years
• Acute ischemic stroke with imaging-confirmed anterior large vessel occlusion at:; Terminal ICA,; M1 segment of the middle cerebral artery, or; Dominant M2 segment
• NIHSS score between 6 and 25 prior to randomization
• Alberta Stroke Program Early CT Score (ASPECTS) of 6-10 before randomization
• Time from symptom onset (or last known well) to planned endovascular thrombectomy within 24 hours
• Pre-stroke mRS score of 0-1
• Patients presenting within 6 hours of symptom onset are eligible for direct EVT. Patients presenting between 6 and 24 hours after symptom onset must undergo advanced imaging demonstrating a salvageable perfusion mismatch and meet the DEFUSE-3 criteria: an infarct core volume <70 mL, a mismatch volume >15 mL, and a mismatch ratio >1.8
• Written informed consent provided by the participant or a legally authorized representative

Ki nem vehet részt

• Simultaneous bilateral anterior-circulation occlusions or concurrent anterior- and posterior-circulation occlusions
• Active bleeding within the previous month (e.g., gastrointestinal, genitourinary, or retinal hemorrhage), major organ surgery or biopsy within 14 days before stroke onset, or known bleeding diathesis
• Previous use of GLP-1 receptor agonists or GIP receptor agonists, or known hypersensitivity to these agents
• History of severe anxiety or depression prior to stroke onset
• Posterior-circulation large vessel occlusion stroke
• Intracranial hemorrhage on baseline CT or MRI, including subarachnoid hemorrhage or intracerebral hemorrhage; evidence of large established infarction, defined as:; ASPECTS <6,; Ischemic core volume ≥70 mL on CTP, or; Infarction involving >1/3 of the middle cerebral artery territory
• Refractory hypertension despite treatment, defined as persistent systolic blood pressure >180 mmHg or diastolic blood pressure >110 mmHg
• Personal or family history of medullary thyroid carcinoma (MTC) or diagnosis of Multiple Endocrine Neoplasia Type 2 (MEN2)
• Severe underlying disease with life expectancy <1 year, such as advanced malignancy
• Severe hepatic or renal impairment, including:; Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m²,; Serum creatinine >200 μmol/L,; Child-Pugh Class C or higher liver disease,; Recurrent unexplained hypoglycemia
• Blood glucose <2.7 mmol/L or >22.2 mmol/L; platelet count <80 × 10⁹/L; or international normalized ratio (INR) >1.7
• Participants meeting any of the following criteria will be excluded:
• Pregnancy or breastfeeding
• Participation in another clinical trial