Evidence map›Paper›PMID 23803136›Full record

Trial reportThe New England journal of medicine2013

Clopidogrel with aspirin in acute minor stroke or transient ischemic attack.

Yongjun Wang, Yilong Wang, Xingquan Zhao, Liping Liu, David Wang, Chunxue Wang, Chen Wang, Hao Li, Xia Meng, Liying Cui and 9 more

13 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 13 registered trials, which are not on this map. Cited by 711 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
711citing papers in PubMed, 22 pooled it
62.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05001984 phase2active not recruitingstarted 2021, after this paper: background citation

Trial of PCSK9 Inhibition in Patients with Acute Stroke and Symptomatic Intracranial Atherosclerosis - a Prospective, Randomized, Open-label, Blinded End-point Study with High-resolution MR Vessel Wall Imaging

Ran2021Enrolled60Registered outcomes11Posted comparisons0ConditionsAcute Ischemic Stroke, ICAS - Intracranial Atherosclerosis, Intracranial AtherosclerosisArmsAlirocumab
PMID 30403574PMID 25824512PMID 16899775PMID 29766750PMID 26671513PMID 30586774PMID 30932785PMID 31338221PMID 31371644PMID 31919104PMID 32333899PMID 24481975other papers from this trial
Open the trial in the graph
NCT00979589 phase3completednot on this map

Randomized,Double-blind Trial Comparing the Effects of a 3-month Clopidogrel Regimen,Combined With ASA During the First 21days,Versus ASA Alone for the Acute Treatment of TIA or Minor Stroke

TypeinterventionalSponsorBeijing Tiantan HospitalRan2009 to 2012Enrolled5,100ConditionsStroke, Transient Ischemic AttackArmsClopidogrel, Placebo of clopidogrel and Asprin
NCT00991029 phase3terminatednot on this map

Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) Trial

TypeinterventionalSponsorUniversity of California, San FranciscoRan2010 to 2018Enrolled4,881ConditionsIschemic Attack, TransientArmsClopidogrel, placebo
NCT02869009 phase3completednot on this mapstarted 2016, after this paper: background citation

Antiplatelet Therapy in Acute Mild-Moderate Ischemic Stroke (ATAMIS): a Parallel Randomized, Open-label, Multicenter, Prospective Study

TypeinterventionalSponsorGeneral Hospital of Shenyang Military RegionRan2016 to 2022Enrolled3,000ConditionsIschemic StrokeArmsclopidogrel, Aspirin
NCT03079674 unknown statusnot on this mapstarted 2017, after this paper: background citation

China Registry of Non-disabling Ischemic Cerebrovascular Events: A Prospective Multi-center, National Registry Trail

Typeobservational_patient_registrySponsorThe First Affiliated Hospital of Zhengzhou UniversityRan2017 to 2020Enrolled10,000ConditionsTransient Ischemic Attack, Minor StrokeArmsobservational only- no intervention
NCT04824911 phase2completednot on this mapstarted 2021, after this paper: background citation

Early Intensive Medical Therapy for the Prevention of Early Neurological Deterioration in Branch Atheromatous Disease

TypeinterventionalSponsorChang Gung Memorial HospitalRan2021 to 2025Enrolled376ConditionsAcute Stroke, Dual Antiplatelet Therapy, StatinArmsClopidogrel, Aspirin, Atorvastatin, Rosuvastatin
NCT05476081 completednot on this mapstarted 2021, after this paper: background citation

A REAl-life Study on Short-term Dual Antiplatelet Treatment in Patients With Ischemic Stroke or Transient Ischemic Attack

Typeobservational_patient_registrySponsorUniversity of L'AquilaRan2021 to 2023Enrolled2,239ConditionsIschemic Stroke, TIAArmsAspirin, Clopidogrel, Ticagrelor
NCT05644314 narecruitingnot on this mapstarted 2022, after this paper: background citation

Efficacy of Drug-Eluting Vertebral Artery Stenting Treatment for Atherosclerotic Vertebral Arteries Stenosis in Real-World Clinical Observations: a Prospective, Multicenter, Open-access, Single-arm Clinical Study

TypeinterventionalSponsorNanfang Hospital, Southern Medical UniversityRan2022 to 2029Enrolled144ConditionsIschemic Stroke, Vertebral Artery StenosisArmsThe drug-eluting stent
NCT05995600 phase4recruitingnot on this mapstarted 2024, after this paper: background citation

Comparison of Clopidogrel-based Antiplatelet Therapy Versus Warfarin As Secondary Prevention Strategy for AntiPhospholipid Syndrome-related STROKE (APS-STROKE)

TypeinterventionalSponsorSeoul National University HospitalRan2024 to 2029Enrolled200ConditionsAntiphospholipid Syndrome, Ischemic Stroke, Transient Ischemic Attack, Cerebrovascular DiseaseArmsAntiplatelet Drug, Warfarin
NCT06243133 phase4unknown statusnot on this mapstarted 2024, after this paper: background citation

Pair Antiplatelet THerapy in Ischemic Stroke With Intracranial Artery Stenosis

TypeinterventionalSponsorSichuan Provincial People's HospitalRan2024 to 2026Enrolled1,100ConditionsIschemic Stroke, Intracranial Arteriosclerosis, Secondary Prevention, Antiplatelet DrugArmsclopidogrel for 90 days combined with aspirin for 90 days, clopidogrel for 30 days combined with aspirin for 90 days
NCT06404242 recruitingnot on this mapstarted 2024, after this paper: background citation

Plaque Characteristics From Vessel Wall Magnetic Resonance Imaging Predict Recurrent Stroke in Ischemic Stroke Patients Due to Middle Cerebral Artery Stenosis

TypeobservationalSponsorUniversity Medical Center Ho Chi Minh City (UMC)Ran2024 to 2026Enrolled75ConditionsHigh Resolution Vessel Wall Imaging, Recurrent Stroke, Stroke, Mechanism, Atheroscleroses, Intracranial
NCT06853535 phase3recruitingnot on this mapstarted 2025, after this paper: background citation

Precision Antiplatelet Therapy Guided by Platelet Aggregation Function in Patients With Acute Ischemic STROKE

TypeinterventionalSponsorSichuan Provincial People's HospitalRan2025 to 2027Enrolled5,138ConditionsAcute Ischemic Stroke, Clopidogrel ResistanceArmsThe ticagrelor, The Clopidogrel
NCT07644234 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Platelet Aggregation Function-Guided De-Escalation Antiplatelet Therapy in Patients With Acute Ischemic Stroke

TypeinterventionalSponsorSichuan Provincial People's HospitalRan2026 to 2029Enrolled3,836ConditionsIschemic Stroke, Transient Ischemic AttackArmsClopidogrel, Aspirin
3 · Its place in the literature

Who cites it

711 citing papers in PubMed, 22 syntheses or guidelines pooled it, 1,807 citations in OpenAlex.

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651 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 11 institutions in 2 countries.

Yongjun WangBeijing Tiantan Hospital, Capital Medical University, Beijing, China. yongjunwang1962@gmail.com
Yilong Wang
Xingquan Zhao
Liping Liu
David Wang
Chunxue Wang
Chen Wang
Hao Li
Xia Meng
Liying Cui
Jianping Jia
Qiang Dong
Anding Xu
Jinsheng Zeng
Yansheng Li
Zhimin Wang
Haiqin Xia
S Claiborne Johnston
CHANCE Investigators
Beijing Tian Tan Hospital · CNCapital Medical University · CNFirst Affiliated Hospital of Jinan University · CNFudan University · CNIllinois College · USRenji Hospital · CNSun Yat-sen University · CNTaiyuan Iron and Steel Group (China) · CNTaizhou First People's Hospital · CNUniversity of California, San Francisco · USXuan Wu Hospital of the Capital Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStroke is common during the first few weeks after a transient ischemic attack (TIA) or minor ischemic stroke. Combination therapy with clopidogrel and aspirin may provide greater protection against subsequent stroke than aspirin alone.

methodsIn a randomized, double-blind, placebo-controlled trial conducted at 114 centers in China, we randomly assigned 5170 patients within 24 hours after the onset of minor ischemic stroke or high-risk TIA to combination therapy with clopidogrel and aspirin (clopidogrel at an initial dose of 300 mg, followed by 75 mg per day for 90 days, plus aspirin at a dose of 75 mg per day for the first 21 days) or to placebo plus aspirin (75 mg per day for 90 days). All participants received open-label aspirin at a clinician-determined dose of 75 to 300 mg on day 1. The primary outcome was stroke (ischemic or hemorrhagic) during 90 days of follow-up in an intention-to-treat analysis. Treatment differences were assessed with the use of a Cox proportional-hazards model, with study center as a random effect.

resultsStroke occurred in 8.2% of patients in the clopidogrel-aspirin group, as compared with 11.7% of those in the aspirin group (hazard ratio, 0.68; 95% confidence interval, 0.57 to 0.81; P<0.001). Moderate or severe hemorrhage occurred in seven patients (0.3%) in the clopidogrel-aspirin group and in eight (0.3%) in the aspirin group (P=0.73); the rate of hemorrhagic stroke was 0.3% in each group.

conclusionsAmong patients with TIA or minor stroke who can be treated within 24 hours after the onset of symptoms, the combination of clopidogrel and aspirin is superior to aspirin alone for reducing the risk of stroke in the first 90 days and does not increase the risk of hemorrhage. (Funded by the Ministry of Science and Technology of the People's Republic of China; CHANCE ClinicalTrials.gov number, NCT00979589.).

Indexed as

AgedAspirinClopidogrelDisease-Free SurvivalDouble-Blind MethodDrug Therapy, CombinationFemaleHemorrhageHumansIschemic Attack, TransientMaleMiddle AgedPlatelet Aggregation InhibitorsProportional Hazards ModelsSecondary PreventionStrokeAspirinClopidogrelPlatelet Aggregation InhibitorsTiclopidine

Identifiers

PMID23803136
OpenAlexW2081615170

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

and 7 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.