Evidence map›Paper›PMID 38836270›Full record

ArticleJournal of stroke2024

The Influence of Non-High-Density Lipoprotein Cholesterol on the Efficacy of Genotype-Guided Dual Antiplatelet Therapy in Preventing Stroke Recurrence.

Qin Xu, Xia Meng, Hao Li, Xuewei Xie, Jing Jing, Jinxi Lin, Yong Jiang, Yilong Wang, Xingquan Zhao, Zixiao Li and 3 more

Abstract read
In one paragraph

Article in Journal of stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
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

13 authors.

Qin XuDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xia MengDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Hao LiDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xuewei XieDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Jing JingDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Jinxi LinDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yong JiangDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yilong WangDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xingquan ZhaoDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Zixiao LiDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Liping LiuDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Anxin WangDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yongjun WangDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Funding

Beijing Municipal Science and Technology CommissionBeijing Natural Science Foundation Haidian original innovation joint fund L222123Chinese Stroke AssociationFund for Young Talents of Beijing Medical Management Center QML20230505Ministry of Science and TechnologyNational Key Research and Development Program of China 2022YFC3600600National Science and Technology Major Project 2017ZX09304018Training Fund for Open Projects at Clinical Institutes and Departments of Capital Medical University CCMU2022ZKYXZ009
6 · The paper itself

Abstract

background and purposeNon-high-density lipoprotein cholesterol (non-HDL-C), which represents the total cholesterol content of all pro-atherogenic lipoproteins, has recently been included as a new target for lipid-lowering therapy in high-risk atherosclerotic patients in multiple guidelines. Herein, we aimed to explore the relationship between non-HDL-C level and the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in preventing stroke recurrence.

methodsThis study comprised a post hoc analysis of the CHANCE-2 (Ticagrelor or Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events II) trial, from which 5,901 patients with complete data on non-HDL-C were included and categorized by median non-HDL-C levels, using a cutoff of 3.5 mmol/L. The primary efficacy and safety outcomes were recurrent stroke and severe or moderate bleeding within 90 days.

resultsTicagrelor-aspirin significantly reduced the risk of recurrent stroke in patients with low non-HDL-C (71 [4.8%] vs. 119 [7.7%]; adjusted hazard ratio [HR] 0.54; 95% confidence interval [CI], 0.40-0.74), but not in those with high non-HDL-C (107 [7.3%] vs. 108 [7.6%]; adjusted HR, 0.88; 95% CI, 0.67-1.16), compared with clopidogrel-aspirin (P for interaction=0.010). When analyzed as a continuous variable, the benefit of ticagrelor-aspirin for recurrent stroke decreased as non-HDL-C levels increased. No significant differences in the treatment assignments across the non-HDL-C groups were observed in terms of the rate of severe or moderate bleeding (5 [0.3%] vs. 8 [0.5%] in the low non-HDL-C group; 4 [0.3%] vs. 2 [0.1%] in the high non-HDL-C group; P for interaction=0.425).

conclusionCHANCE-2 participants with low non-HDL-C levels received more clinical benefit from ticagrelor-aspirin versus clopidogrel-aspirin compared to those with high non-HDL-C, following minor ischemic stroke or transient ischemic attack.

Indexed as

CHANCE-2ClopidogrelNon–high-density lipoprotein cholesterolStrokeTicagrelor

Identifiers

PMID38836270
PMCPMC11164593

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.