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Small studies have suggested that argatroban, a direct thrombin inhibitor, could be beneficial when added to thrombolysis in patients with acute ischemic stroke. However, no large randomized studies have evaluated this treatment approach. These authors conducted a randomized trial at 50 centers in China. Patients with acute ischemic stroke who could be treated within 4.5 hours were randomly assigned to argatroban plus alteplase (combined group) or alteplase alone. The primary outcome was excellent neurologic status at 90 days, judged by a score of 0–1 on the modified Rankin scale. Secondary outcomes included symptomatic brain hemorrhage. Argatroban patients received a 100-µg/kg bolus, followed by a 1-µg/kg infusion for 48 hours. Alteplase w…