Clinical Research Directory

Inclusion Criteria: 1. LVO stroke at terminal ICA, M1 or dominant M2 with an LKW-to-randomization ≤24 hours 2. Age ≥ 18 years old 3. National Institute of Health Stroke Scale ≥ 6 at the time of brain imaging 4. Acute LVO stroke due to thromboembolism or intracranial stenosis 5. Patients who received computer tomographic or magnetic resonance angiography 6. ASPECTS ≥ 6 for patients with LKW-to-randomization ≤6 hours 7. Salvageable ischemic penumbra demonstrated by CT perfusion or MRI for patients with LKW-to-randomization between 6 and 24 hours 8. Informed consent obtained from patient or acceptable patient surrogate. Exclusion Criteria: 1. Use of intravenous thrombolytic therapy (alteplase or tenecteplase) 2. Pre-stroke mRS \> 2 for patients \<80 years and \> 1 for patients ≥ 80 years old 3. Intracranial hemorrhage or brain tumour on initial imaging (except small meningiomas) 4. Simultaneous occlusion of bilateral anterior circulation, or both anterior and posterior circulation 5. Unstable hemodynamics on presentation that require resuscitation 6. Systolic blood pressure \>185mmHg or diastolic blood pressure \>110mmHg that cannot be controlled by antihypertensive drugs 7. Severe comorbid illness, e.g. terminal malignancy with life expectancy \<1 year 8. Pregnant or lactating female 9. Participation in another clinical trial 10. Contraindications to GLP1-RA, including history of allergy to GLP-1RA, family or personal history of multiple endocrine neoplasia, medullary thyroid or pancreatic carcinoma, or proliferative diabetic retinopathy 11. Blood glucose \<2.7 or \> 22.2 mmol/L; platelet count \<50x10\^9 /L; INR \>1.7 12. Patients with known estimated glomerular filtration rate of \<30ml/min/1.73m2 or creatinine \>3mg/dL (265.2µmol/L); chronic liver disease with Child's Pugh score C or above; or recurrent unexplained hypoglycemia. 13. Suspected or confirmed vasculitis of the central nervous system 14. Unable to complete 90-day follow-up assessment