Evidence mapPaperPMID 39773886Full record

Trial reportStroke and vascular neurology2025

Dual antiplatelet therapy with ticagrelor vs clopidogrel in patients with TIA or minor stroke with or without symptomatic carotid artery stenosis: a post hoc analysis of the CHANCE-2 trial.

Xuewei Xie, Jing Jing, Anxin Wang, Qin Xu, Xingquan Zhao, Jinxi Lin, Pan Chen, Yong Jiang, Yilong Wang, Hao Li and 2 more

Registry-linked trialAbstract readComparative StudyRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Stroke and vascular neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04078737 (Clopidogrel With Aspirin in High-risk Patients With Acute Non-disabling Cerebrovascular Events II), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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.

NCT04078737 phase3completednot on this map

Clopidogrel With Aspirin in High-risk Patients With Acute Non-disabling Cerebrovascular Events II

TypeinterventionalSponsorBeijing Tiantan HospitalRan2019 to 2021Enrolled6,412ConditionsStroke, Transient Ischemic AttackArmsTicagrelor and Aspirin, Clopidogrel and Aspirin
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

12 authors.

Xuewei Xie *China National Clinical Research Center for Neurological Diseases, Beijing, China.ORCID 0000-0001-8154-1957
Jing Jing *China National Clinical Research Center for Neurological Diseases, Beijing, China.ORCID 0000-0001-9822-5758
Anxin WangChina National Clinical Research Center for Neurological Diseases, Beijing, China.
Qin XuChina National Clinical Research Center for Neurological Diseases, Beijing, China.ORCID 0000-0002-8039-709X
Xingquan ZhaoChina National Clinical Research Center for Neurological Diseases, Beijing, China.ORCID 0000-0001-8345-5147
Jinxi LinChina National Clinical Research Center for Neurological Diseases, Beijing, China.
Pan ChenChina National Clinical Research Center for Neurological Diseases, Beijing, China.
Yong JiangChina National Clinical Research Center for Neurological Diseases, Beijing, China.ORCID 0000-0001-7700-6054
Yilong WangChina National Clinical Research Center for Neurological Diseases, Beijing, China.ORCID 0000-0002-3267-0039
Hao LiChina National Clinical Research Center for Neurological Diseases, Beijing, China.ORCID 0000-0002-8591-4105
Xia MengChina National Clinical Research Center for Neurological Diseases, Beijing, China.
Yongjun WangChina National Clinical Research Center for Neurological Diseases, Beijing, China yongjunwang@ncrcnd.org.cn.ORCID 0000-0002-9976-2341

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeSymptomatic internal carotid artery stenosis (sCAS) is an essential cause of transient ischaemic attack (TIA) or minor stroke. We aimed to evaluate whether the superiority of aspirin-ticagrelor over aspirin-clopidogrel varies between patients with sCAS or not.

methodsThis was a post-hoc analysis of the High-Risk Patients with Acute Nondisabling Cerebrovascular Events-II (CHANCE-2) trial, all of which were

resultsA total of 5920 (92.3%) from 6412 were analysed, including 197 (3.3%) with sCAS and 5723 (96.7%) without sCAS. Stroke recurrence occurred in 13 (12.15%) and 11 (12.22%) patients with sCAS who received aspirin-ticagrelor and aspirin-clopidogrel, respectively (adjusted HR, 1.04; 95% CI, 0.46 to 2.36; p=0.930). Among patients without sCAS, there were 158 cases (5.52%) of new strokes in the aspirin-ticagrelor group and 222 cases (7.76%) in the aspirin-clopidogrel group (HR, 0.70; 95% CI, 0.57 to 0.86; p=0.0006). The treatment-by-sCAS subtype was not significant (p=0.405).

conclusionsGenotype-guided dual antiplatelet treatment with aspirin-ticagrelor may be beneficial for preventing recurrent strokes in patients without sCAS; however, it appears less effective in those with sCAS. No significant interaction was found between the treatment and sCAS subtypes. TRIAL REGISTRATION NUMBER: NCT04078737.

Indexed as

AspirinCarotid StenosisClopidogrelDual Anti-Platelet TherapyIschemic Attack, TransientPlatelet Aggregation InhibitorsStrokeTicagrelorAgedCytochrome P-450 CYP2C19FemaleHumansMaleMiddle AgedPharmacogenomic VariantsPhenotypeAspirinClopidogrelCYP2C19 protein, humanCytochrome P-450 CYP2C19Platelet Aggregation InhibitorsTicagrelorCarotid StenosisStroke

Identifiers

PMID39773886
PMCPMC12573349

What Socratic holds

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LicenceCC BY-NC
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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.