Effects of alteplase, aspirin, and clopidogrel on inflammatory factors and neurological function in patients with stroke

Aim To evaluate the clinical value of combining alteplase, aspirin, and clopidogrel in patients with stroke, with changes in the National Institutes of Health Stroke Scale (NIHSS) score as the primary efficacy assessment indicator.Methods Clinical data of 122 patients with stroke who received pharmacological treatment between January 2022 and June 2024 were retrospectively collected from the hospital's health information technology (HIT) system. Patients were assigned to two groups according to treatment protocols: a dual-agent group (n = 61; aspirin plus alteplase) and a triple-agent group (n = 61; alteplase, aspirin, and clopidogrel).Results At 24 h, 3 days, and 5 days of treatment, NIHSS scores were lower in the triple-agent group than in the dual-agent group, with a significantly higher NIHSS improvement rate at 5 days (85.0% vs. 75.0%, P = 0.022). At 5 days and at 90-day follow-up, Montreal Cognitive Assessment (MoCA) scores were significantly higher in the triple-agent group (P = 0.002, P < 0.001). The dual-agent group had a longer duration of hospitalization but lower average medical costs than the triple-agent group (P = 0.025). No significant difference in 90-day complication incidence was observed between the groups (P > 0.05). At the 90-day follow-up, the triple-agent group demonstrated significantly better upper and lower limb function and higher Barthel scores compared with the dual-agent group (P < 0.001).Conclusion Triple-agent therapy, with alteplase, aspirin, and clopidogrel, may reduce neurological impairment, improve cognitive outcomes, and enhance early functional recovery in patients with stroke, although at the expense of higher medical costs.