Evidence mapPaperPMID 30747613Full record

ArticleInternational journal of stroke : official journal of the International Stroke Society2019

The Acute S

S Claiborne Johnston, Pierre Amarenco, Hans Denison, Scott R Evans, Anders Himmelmann, Stefan James, Mikael Knutsson, Per Ladenvall, Carlos A Molina, Yongjun Wang and 1 more

Registry-linked trialOpen access · hybridAbstract readClinical Trial Protocol
In one paragraph

Article in International journal of stroke : official journal of the International Stroke Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03354429 (A Randomised, Double-Blind, Placebo-Controlled, International, Multicentre, Phase III Study to Investigate the Efficacy and Safety of Ticagrelor and ASA Compared With ASA in the Prevention of Stroke and Death in Patients With Acute Ischaemic Stroke or Transient Ischaemic Attack), which is not on this map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
4.7field-weighted citation impact, top 4% 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.

NCT03354429 phase3completednot on this map

A Randomised, Double-Blind, Placebo-Controlled, International, Multicentre, Phase III Study to Investigate the Efficacy and Safety of Ticagrelor and ASA Compared With ASA in the Prevention of Stroke and Death in Patients With Acute Ischaemic Stroke or Transient Ischaemic Attack

TypeinterventionalSponsorAstraZenecaRan2018 to 2019Enrolled11,016ConditionsAcute Ischaemic Stroke, Transient Ischaemic AttackArmsTicagrelor, Placebo
3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

  1. Pooled it
  2. Trial
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  5. Article
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  9. A Review of the Role of the Antiplatelet Drug Ticagrelor in the Management of Acute Coronary Syndrome, Acute Thrombotic Disease, and Other Diseases.Medical science monitor : international medical journal of experimental and clinical research · 2022
    Review
  10. Article
  11. P2Y12 inhibitors for the neurointerventionalist.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2022
    Review
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  14. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 5 countries.

S Claiborne JohnstonDell Medical School, University of Texas at Austin, Austin, TX, USA.ORCID 0000-0002-2912-0714
Pierre AmarencoDepartment of Neurology and Stroke Centre, Bichat Hospital, Paris Diderot, Paris, France.ORCID 0000-0002-3842-1236
Hans DenisonGlobal Medicines Development, AstraZeneca, Gothenburg, Sweden.
Scott R EvansBiostatistics Center, George Washington University, Washington DC, MD, USA.
Anders HimmelmannGlobal Medicines Development, AstraZeneca, Gothenburg, Sweden.
Stefan JamesDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.
Mikael KnutssonGlobal Medicines Development, AstraZeneca, Gothenburg, Sweden.
Per LadenvallGlobal Medicines Development, AstraZeneca, Gothenburg, Sweden.
Carlos A MolinaStroke Unit, Hospital Vall d'Hebron, Barcelona, Spain.
Yongjun WangDepartment of Neurology, Beijing Tiantan Hospital, Beijing, China.
THALES Investigators
AstraZeneca (Sweden) · SEBeijing Tian Tan Hospital · CNDélégation Paris 7 · FRGeorge Washington University · USThe University of Texas at Austin · USUppsala University · SEVall d'Hebron Hospital Universitari · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleIn patients with acute cerebral ischemia, the rate of stroke, myocardial infarction, or death during 90 days was reported to be non-significantly lower with ticagrelor compared with aspirin, with no increase in major hemorrhage. Dual antiplatelet therapy may be more effective in this setting.

aimTo investigate whether ticagrelor combined with aspirin are superior to aspirin alone in preventing stroke or death in patients with non-severe, non-cardioembolic ischemic stroke or high-risk transient ischemic attack.

designThe Acute Stroke or Transient Ischemic Attack Treated with Ticagrelor and Aspirin for Prevention of Stroke and Death (THALES) trial is a randomized, placebo-controlled, double-blind, event-driven study. Patients will be randomized within 24 h of onset of acute ischemic symptoms. THALES is expected to randomize 13,000 at ∼450 sites worldwide, to collect 764 primary outcome events. Study treatments are ticagrelor 180 mg loading dose on day 1, then 90 mg twice daily on days 2-30, or matching placebo. All patients will also receive open-label aspirin 300-325 mg on day 1, then 75-100 mg once daily on days 2-30. STUDY OUTCOMES: The primary efficacy outcome is time to the composite endpoint of stroke or death through 30-day follow-up. The primary safety outcome is time to first severe bleeding event. DISCUSSION: The THALES trial will provide important information about the benefits and risks of dual antiplatelet therapy with ticagrelor and aspirin in patients with acute cerebral ischemia in a global setting (funding: AstraZeneca). CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov . Unique identifier: NCT03354429.

Indexed as

AgedAged, 80 and overAspirinClinical Trials, Phase III as TopicDouble-Blind MethodDrug Therapy, CombinationFemaleHumansIschemic Attack, TransientMaleMiddle AgedMulticenter Studies as TopicPlatelet Aggregation InhibitorsRandomized Controlled Trials as TopicResearch DesignStrokeAspirinPlatelet Aggregation InhibitorsTicagrelorantiplateletaspirincerebral ischemiaStrokeTIAticagrelor

Identifiers

PMID30747613
PMCPMC6826854
OpenAlexW2911427894

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.