Indobufen versus aspirin in patients with acute ischaemic stroke in China (INSURE): a randomised, double-blind, double-dummy, active control, non-inferiority trial

Pan, Yuesong; Meng, Xia; Yuan, Baoshi; Johnston, S. Claiborne; Li, Hao; Bath, Philip M; Xu, Anding; Jing, Jing; Lin, Jinxi; Jiang, Yong; Xie, Xuewei; Jin, Aoming; Suo, Yue; Xiong, Yunyun; Li, Zixiao; Wang, Yilong; Wang, Wenjuan; Liu, Liping; Wang, Yongjun; Wang, Yanxia; Wang, Cunrui; Han, Yazhou; Yu, Ming; Yang, Hongqin; Zou, Guoping; Wu, Aisheng; Zhang, Guiru; Zhang, Ping; Yan, Mingzong; Zhang, Jia; Zhao, Jingyan; Zhang, Huitian; Qi, Qinde; Zhang, Jianling; Zhu, Zhitao; Zhao, Jinhui; Fan, Wenfeng; Li, Xueli; Chang, Liguo; Tan, Lei; Zhao, Liang; Xue, Yi; Liu, Peiru; Ju, Xiaohua; Zhang, Zuowen; Li, Linwen; Feng, Wang; Yang, Lixia; Li, Xuemei; Zheng, Zemin; Liang, Hui; Wei, Yan; Zhang, Ming; Wang, Ting; Yang, Jian‐Bo; Liu, Qing; Huang, Panbing; Tan, Guojun; Chen, Yongming; Zhou, Jin; An, Zhuoling; Li, Chunlei; Chen, Guohua; Zhu, Runxiu; Sun, Xin; Liu, Yong; Zhang, Mei; Zhuo, Yanguang; Meng, Fanchao; Zhu, Hui; Li, Kebo; Chai, Xiangting; Deng, Ke; Li, Jianhua; Cai, Zhiyou; Jin, Hailian; Li, Bo; Zhang, Xiaomei; Ge, Beihai; Hu, Wei; Jiao, Zhen; Zhong, Lianmei; Ren, Lijie; Li, Xinyi; Wu, Songdi; Wan, Yinguo; Zhang, Jinghua; Ma, Xiaoyan; Hu, Jizheng; Zhang, Ge; Zheng, Chunling; Xu, Jun; Zou, Yuan; Huang, Xuerong; Duan, Zhihui; Li, Changxin; Zhang, Qingxiu; Song, Xiaoming; Jia, Zhengchang; Wang, Chun; Shao, Peining; Teng, Jijun; Bao, Hua; Chen, Yang-Kun; Wei, Yunfei; Zhang, Xu; Meng, Xisi; Li, Guangning; Feng, Yan Ting; Pan, Pengke; Zhuang, Aixia; Dong, Qiang; Chen, Xiaofei; Zhou, Yanhua; Tanida, Jun; An, Honglei; You, Shihao; Zhang, Wei; Tang, Yanyan; Zhang, Guilian; Li, Hongyan; Guo, Miao; Chen, Yu; Liu, Ying; Liu, Haichao; Liang, Ping; Kang, Guixia; Sun, Hongqi; Yu, Chen; Tang, Juan; Li, Dandan; Feng, Xiaopeng; Geng, Yong; Liu, Bin; Wang, Huibing; Shen, Ping; Zhu, Hui-ren; Li, Farong; Zhang, Lifang; Cao, Minghua; Yong, You; Cui, Guiyun; Gu, Jun; Li, Haitao; Zhang, Xiangfeng; Liu, Xiaojun; Chen, Houqin; Zhang, Yuehua; Zhao, Hongnian; Liang, Ke; Zhi, Rui; Li, Ma; Wu, Yuanhua; Geng, Yalan; Sun, Ping; Zhong, Bing; Li, Dongxue; Jiao, Jingya; Hao, Yanlei; Li, Guozhong; Su, Shao-Hua; Wang, Ju; Liu, Min; Guo, Lingjun; Shangguan, Yafei; Tai, Yingdong; Xing, Ying; Chang, Hongshan; Chen, Wenya; Tang, Hongtao; Huang, Shuchun; Fang, Jingxian; Yu, Donghui; Zhao, Hailong; Xu, Lei; Wu, Aimei; Wan, Hebin; Wang, Hongliang; Zhang, Shen; Zhang, Qing; Wang, Qian

doi:10.1016/s1474-4422(23)00113-8

Cited by 9 publications

(2 citation statements)

References 29 publications

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“…Clopidogrel [44] , aspirin-dipyridamole combination [70][71] , and cilostazol [72][73] have been shown to be at least non-inferior to aspirin in the secondary prevention of ischemic stroke/TIA. In patients with acute moderateto-severe ischemic stroke (National Institutes of Health Stroke Scale [NIHSS] score, 4-18), indobufen did not achieve noninferiority to aspirin, and the two groups were similar in terms of bleeding and overall adverse events [74] .…”

Section: Anti-thrombotic Therapy For Cad Patientsmentioning

confidence: 99%

Chinese expert consensus on anti-thrombotic therapy for pan-vascular diseases (2023 edition)

2024

Cardiology Plus

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Pan-vascular disease is a systemic condition characterized by vascular lesions, with atherosclerosis comprising 95% of cases, manifesting as coronary artery disease, cerebrovascular disease, peripheral artery disease, or combinations thereof, known as multivascular disease. In China, the burden of pan-vascular diseases is substantial, necessitating urgent improvements in patient prognosis. Despite being managed by different disciplines, pan-vascular diseases often share common risk factors and pathophysiological mechanisms, underscoring the need for standardized treatment strategies. Anti-thrombotic therapy for pan-vascular diseases primarily involves antiplatelet and anticoagulant therapy. Currently, there is a lack of unified guidance across various disciplines for patients with differing ischemic and bleeding risks and disease stages. Recognizing the pivotal role of standardized anti-thrombotic therapy in pan-vascular disease treatment, the Chinese College of Cardiovascular Physicians organized a consensus working group comprising 33 senior experts from cardiology, vascular surgery, neurology, and endocrinology. The “Chinese expert consensus on anti-thrombotic therapy for pan-vascular diseases (2023 Edition)” was developed based on specific treatment needs in China, incorporating published clinical research evidence, specialized guidelines and consensus, and recommendations from the consensus expert group. The primary aim of this consensus is to standardize the application of anti-thrombotic therapy in pan-vascular diseases, thereby optimizing clinical outcomes, improving patient prognosis, and mitigating the economic and societal burdens associated with pan-vascular disease.

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Section: Anti-thrombotic Therapy For Cad Patientsmentioning

confidence: 99%

Chinese expert consensus on anti-thrombotic therapy for pan-vascular diseases (2023 edition)

2024

Cardiology Plus

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“…Some studies have started to investigate different antiplatelet agents for patients with moderate-to-severe stroke or those with a high risk of bleeding. [ 82 ] However, there is no confirmed evidence to inform practice, and more research is needed for this group of patients.…”

Section: Clinical Managementmentioning

confidence: 99%

Definition, prediction, prevention and management of patients with severe ischemic stroke and large infarction

Hua,

Liu,

2023

Chinese Medical Journal

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Severe ischemic stroke carries a high rate of disability and death. The severity of stroke is often assessed by the degree of neurological deficits or the extent of brain infarct, defined as severe stroke and large infarction, respectively. Critically severe stroke is a life-threatening condition that requires neurocritical care or neurosurgical intervention, which includes stroke with malignant brain edema, a leading cause of death during the acute phase, and stroke with severe complications of other vital systems. Early prediction of high-risk patients with critically severe stroke would inform early prevention and treatment to interrupt the malignant course to fatal status. Selected patients with severe stroke could benefit from intravenous thrombolysis and endovascular treatment in improving functional outcome. There is insufficient evidence to inform dual antiplatelet therapy and the timing of anticoagulation initiation after severe stroke. Decompressive hemicraniectomy (DHC) <48 h improves survival in patients aged <60 years with large hemispheric infarction. Studies are ongoing to provide evidence to inform more precise prediction of malignant brain edema, optimal indications for acute reperfusion therapies and neurosurgery, and the individualized management of complications and secondary prevention. We present an evidence-based review for severe ischemic stroke, with the aims of proposing operational definitions, emphasizing the importance of early prediction and prevention of the evolution to critically severe status, summarizing specialized treatment for severe stroke, and proposing directions for future research.

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Les antiplaquettaires dans l’ischémie cérébrale aiguë : limites et perspectives

Leys,

Deplanque

2024

Bulletin de l'Académie Nationale de Médecine

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Indobufen versus aspirin in patients with acute ischaemic stroke in China (INSURE): a randomised, double-blind, double-dummy, active control, non-inferiority trial

Cited by 9 publications

References 29 publications

Chinese expert consensus on anti-thrombotic therapy for pan-vascular diseases (2023 edition)

Chinese expert consensus on anti-thrombotic therapy for pan-vascular diseases (2023 edition)

Definition, prediction, prevention and management of patients with severe ischemic stroke and large infarction

Les antiplaquettaires dans l’ischémie cérébrale aiguë : limites et perspectives

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