Evidence mapPaperPMID 40673545Full record

Trial reportJournal of the American Heart Association2025

Dual Antiplatelet Therapy in Patients With Metabolic Syndrome After Mild Ischemic Stroke or Transient Ischemic Attack.

Zhang Xia, Ying Gao, Weiqi Chen, S Claiborne Johnston, Pierre Amarenco, Philip M Bath, Xuan Wang, Hongyi Yan, Tingting Wang, Yingying Yang and 7 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03635749 (Intensive Statin and Antiplatelet Therapy for High-risk Intracranial or Extracranial Atherosclerosis), which is not on this map. Not yet cited in PubMed.

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

NCT03635749 phase3unknown statusnot on this map

Intensive Statin and Antiplatelet Therapy for High-risk Intracranial or Extracranial Atherosclerosis (INSPIRES)

TypeinterventionalSponsorBeijing Tiantan HospitalRan2018 to 2023Enrolled6,100ConditionsAcute Stroke, Transient Ischemic AttackArmsIntensive antiplatelet, Standard antiplatelet, Immediate high-intensity statin, Delayed high-intensity statin
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

17 authors.

Zhang XiaDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0001-8833-773X
Ying GaoDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.
Weiqi ChenDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0002-2551-9314
S Claiborne JohnstonDepartment of Neurology University of California San Francisco CA USA.ORCID 0000-0002-2912-0714
Pierre AmarencoDepartment of Neurology and Stroke Center Assistance Publique-Hôpitaux de Paris (APHP), Bichat Hospital, INSERM LVTS-U1148, University of Paris France.ORCID 0000-0002-3842-1236
Philip M BathStroke Trials Unit, Mental Health & Clinical Neuroscience University of Nottingham United Kingdom.ORCID 0000-0003-2734-5132
Xuan WangDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0001-5929-6916
Hongyi YanDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0001-5190-6345
Tingting WangDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0002-3809-2209
Yingying YangDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0001-9431-9925
Yanli ZhangDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0002-2949-9218
Mengxing WangDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.
Jing JingDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0001-9822-5758
Chunjuan WangDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0002-1627-5004
Yongjun WangDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0002-9976-2341
Yilong WangDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0003-2725-2788
Yuesong PanDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.ORCID 0000-0003-3082-6789

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetabolic syndrome (MetS) attenuates antiplatelet agent effects. This study investigated the efficacy and safety of clopidogrel-aspirin therapy for secondary stroke prevention in patients with MetS.

methodsData were obtained from the INSPIRES (Intensive Statin and Antiplatelet Therapy for Acute High-Risk Intracranial or Extracranial Atherosclerosis) trial. Patients with mild ischemic stroke or high-risk transient ischemic attack were randomized to treatment with clopidogrel-aspirin or aspirin alone within 72 hours after symptom onset. MetS was defined according to the Adult Treatment Panel-III. The primary efficacy outcome was new stroke, and the primary safety outcome was moderate - to - severe bleeding within 90-day follow-up. Differences between groups were estimated with Cox proportional hazards models, with hazard ratio (HR) and 95% CI presented.

resultsThis study included 4715 patients, with a mean age of 63.7±9.6 years, 35.8% of women, and 75.8% of patients having MetS. After adjustment for potential confounders, patients with MetS were at higher risk of recurrent stroke (HR, 1.39 [95% CI, 1.06-1.82];

conclusionsMetS was associated with higher risk of recurrent stroke at 90 days. There was no difference in the effect of clopidogrel-aspirin therapy on reducing new stroke and increasing moderate-to-severe bleeding events between patients with and without MetS. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03635749.

Indexed as

AspirinClopidogrelDual Anti-Platelet TherapyIschemic Attack, TransientIschemic StrokeMetabolic SyndromePlatelet Aggregation InhibitorsSecondary PreventionAgedFemaleHemorrhageHumansMaleMiddle AgedRecurrenceRisk FactorsAspirinClopidogrelPlatelet Aggregation Inhibitorsdual antiplatelet therapyischemic strokemetabolic syndromesecondary prevention

Identifiers

PMID40673545
PMCPMC12449989

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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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.