Evidence mapPaperPMID 41565167Full record

ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2026

Aspirin-ticagrelor use after mild acute ischemic stroke: Findings from the get with the guidelines-stroke registry.

Ava L Liberman, Cenai Zhang, Sara K Rostanski, Hooman Kamel, Babak B Navi, Natalie T Cheng, Radhika Sundararajan, Steven R Messe, Gregg C Fonarow, Shyam Prabhakaran and 1 more

Abstract readComparative Study
In one paragraph

Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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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.

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

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

11 authors.

Ava L LibermanClinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA. Electronic address: all9188@med.cornell.edu.
Cenai ZhangClinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.
Sara K RostanskiDepartment of Neurology, Langone School of Medicine at New York University, New York, NY, USA.
Hooman KamelClinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.
Babak B NaviClinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.
Natalie T ChengClinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.
Radhika SundararajanDepartment of Emergency Medicine, Weill Cornell Medicine, New York, NY, USA.
Steven R MesseDepartment of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Gregg C FonarowDivision of Cardiology, Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Shyam PrabhakaranDepartment of Neurology, University of Chicago, Chicago, IL, USA.
Ying XianDepartment of Neurology, University of Texas Southwestern, Dallas, TX, USA.

Funding

Balancing Risks and Benefits of Direct Oral Anticoagulants in Older Ischemic Stroke Patients with Atrial FibrillationR01AG066672 · NIA · UT SOUTHWESTERN MEDICAL CENTER · 2024 to 2025
$965k
NIA NIH HHS R01 AG062770NIA NIH HHS R01 AG066672
6 · The paper itself

Abstract

backgroundRecent guidelines suggest that aspirin-ticagrelor may be considered for stroke prevention after mild acute ischemic stroke. However, it is unclear how commonly this dual antiplatelet therapy (DAPT) regimen is used in practice.

methodsWe performed a cross-sectional analysis of the Get With The Guidelines-Stroke registry 2017-2023. Patients with a non-cardioembolic mild ischemic stroke (defined as NIHSS <6) who presented within 24 hours of last known well without a contraindication to DAPT were included. The primary study outcome was the proportion of patients prescribed aspirin-ticagrelor at hospital discharge; temporal patterns of prescribing aspirin-ticagrelor and aspirin-clopidogrel over time are also described. In addition to standard tests of comparison, we used multiple logistic regression to evaluate associations between patient and facility factors and aspirin-ticagrelor use reported as odds ratios (OR) with 95% confidence intervals (CI).

resultsAmong 1,018,736 patients meeting study criteria, 478,049 (46.9%) were female and median age was 68 (IQR: 59, 78) years. A total of 12,845 (1.3%) patients were discharged on aspirin-ticagrelor whereas 448,348 (44.0%) were discharged on aspirin-clopidogrel. Prescriptions for aspirin-ticagrelor and for aspirin-clopidogrel significantly increased over the study time-period. In regression analysis, coronary artery disease/prior myocardial infarction (OR: 2.6 [95% CI: 2.5-2.7]), Asian race (OR: 2.1 [95% CI: 1.9-2.2]), aspirin-clopidogrel prescription upon admission (OR: 2.0 [95% CI:1.9-2.1]), and history of stroke/TIA (OR: 1.98 [95% CI: (1.9-2.1)]), were substantially associated with aspirin-ticagrelor use whereas lacking insurance/self-pay (OR: 0.7 [95% CI: 0.6-0.8]), rural setting (OR: 0.8 [95% 0.7-0.9]), and primary stroke centers (OR: 0.3 [95% CI: 0.3-0.4]) were inversely associated with aspirin-ticagrelor. In the subgroup of 176,897 (17.4%) patients with NIHSS 4-5, 74,912 (50.8%) were discharged on aspirin-clopidogrel and 2,394 (1.4%) on aspirin-ticagrelor.

conclusionUnlike aspirin-clopidogrel, aspirin-ticagrelor is infrequently administered after mild acute ischemic stroke (NIHSS <6) despite current guidelines, though the use of both DAPT regimens increased over time.

Indexed as

AspirinDual Anti-Platelet TherapyIschemic StrokePlatelet Aggregation InhibitorsPractice Patterns, Physicians'Secondary PreventionAgedAged, 80 and overClopidogrelCross-Sectional StudiesFemaleGuideline AdherenceHumansMaleMiddle AgedPatient DischargeAspirinClopidogrelPlatelet Aggregation InhibitorsDual Antiplatelet TherapyIschemic StrokeSecondary Stroke PreventionTicagrelor

Identifiers

PMID41565167
PMCPMC13131027

What Socratic holds

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Registered trials

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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.