Association Between Argatroban and Outcomes of Branch Atheromatous Disease: A Propensity-Matched Analysis From MRI-Based Study

BACKGROUND AND PURPOSE: Argatroban is widely used for patients with acute branch atheromatous disease (BAD)-related stroke, but its efficacy remains unclear. This study aims to evaluate its clinical outcomes in this patient population. METHODS: A prospective, MRI-based cohort (BAD-study) was conducted across 20 hospitals in China from June 2021 to June 2023, enrolling patients aged 18-80 years with BAD-related stroke within 72 h of onset. Patients were divided into two groups: Argatroban and non-argatroban. The primary outcome was an excellent outcome, defined as a modified Rankin Scale (mRS) score of 0-1 at 90 days. Secondary outcomes included good outcome (mRS 0-2), mRS score, Barthel Index score at 90 days, and NIHSS score at 7 days. Logistic regression analyses were performed to assess the association between argatroban and outcomes after propensity score matching (PSM). RESULTS: A total of 467 patients were included, with a median age of 60 years and a median NIHSS score of 4 at admission. Eighty-six patients (18.4%) were in the argatroban group, and 381 patients (81.6%) were in the non-argatroban group. After PSM, excellent outcomes occurred in 60.0% of the argatroban group and 64.2% of the non-argatroban group (odds ratio [OR] = 0.84, 95% CI: 0.47-1.49, p = 0.542). Argatroban was not significantly associated with secondary outcomes and remained ineffective in sensitivity analyses. CONCLUSION: Argatroban was not associated with excellent outcome at 90 days in patients with acute BAD-related stroke. Our study suggests that the risks and benefits of argatroban need reevaluation in patients with BAD-related stroke.

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In a propensity-matched analysis of a prospective MRI cohort of 467 patients with acute branch atheromatous disease stroke, argatroban was not associated with excellent 90-day outcome (60.0% vs 64.2%; OR 0.84).

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