SLGT2i for Neuroprotection in Patients With Acute Ischemic Stroke

Sodium-dependent Glucose Transporters 2 Inhibitor for Neuroprotection in Patients With Acute Ischemic Stroke

Stroke is a leading cause of disability and mortality globally. With population aging, ischemic stroke (80% of cases) has become China's primary cause of adult disability. Sodium-dependent glucose transporters 2 inhibitors （SGLT2i） demonstrate cardiovascular protection beyond glycemic control, even in patients without diabetes.

Preclinical studies suggest neuroprotective effects via improving cerebral glucose metabolism, anti-inflammatory/antioxidant actions, and reducing neuronal apoptosis. Therefore, the investigators aim to evaluate whether SGLT2i could improve 3-month functional outcomes (mRS scores) in AIS patients compared to standard care.

Inclusion Criteria:

• Age ≥ 18 years
• Patients with acute ischemic stroke (AIS) within ≤ 3 days of onset, with no restrictions on reperfusion therapy
• NIHSS score of 4-25 at the time of randomization
• Pre-stroke mRS score ≤ 1
• Signed informed consent form

Exclusion Criteria:

• Presence of intracranial hemorrhage at the time of randomization
• BMI ≤ 18 kg/m²
• Severe renal insufficiency (eGFR < 30 mL/min) or severe liver impairment (Child-Pugh Class C liver function)
• Type 1 diabetes mellitus
• Blood glucose level < 2.7 mmol/L or > 22.2 mmol/L at the time of randomization
• Systolic blood pressure < 95 mmHg at the time of randomization
• History of heart failure
• Use of SGLT-2 inhibitors within 4 weeks prior to randomization
• Intolerance to SGLT-2 inhibitors
• Life expectancy < 3 months
• Pregnant or lactating women
• Already enrolled in another clinical trial
• Other conditions deemed inappropriate for inclusion by the investigator