Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Antiplatelet effect of ticagrelor with aspirin in acute minor stroke and transient ischemic attack stratified by CYP2C19 metabolizer status: subgroup analysis of the PRINCE trial
First author：Mengyuan Zhou,Weiqi Chen
Corresponding author：Yilong Wang
essential_information
- Person in charge：Mengyuan Zhou,Weiqi Chen
- Data Sources： PRINCE
- Number of papers：PRINCE20210033
- Published time：2020-12-19
2020-12-19
Published articles
Journal：Aging
Publication type: Original Contributions
IF(IF): 4.831
PMID: 33411687 Link To Pubmed Full text Download
Background And Purpose
Studies on antiplatelet effect of ticagrelor/aspirin and clopidogrel/aspirin in patients with acute minor strokeand transient ischemic attack (TIA) stratified by CYP2C19 metabolizer status is limited.
Method
We gained data from thePlatelet Reactivity In Non-disabling Cerebrovascular Events study. Platelet reactivity was tested at baseline, 2 hours, 24 hours, 7 days and 90 days after initial dose, including high on-treatment platelet reactivity (HOPR), which was defined as P2Y12 reaction unit >208, and percentage inhibition of platelet aggregation (IPA).
Conclusion
Our findings showed that ticagrelor/aspirin therapy possessed greater platelet inhibition and more rapid onset in platelet inhibition compared with clopidogrel/aspirin therapy both in carriers and non-carriers of CYP2C19 lose-of-function alleles with acute minor stroke or TIA.
Main results
A total of 365 patients were included. There were 199 (54.5%) individuals lassified as carriers of CYP2C19 loss-offunction alleles. For carriers and non-carriers, the proportions of HOPR were significantly lower in those with ticagrelor/aspirin compared with those with clopidogrel/aspirin at 2 hours, 24 hours, 7 days, respectively (all p<0.05). IPA was higher at all time points except at baseline in patients with ticagrelor/aspirin compared with those with clopidogrel/aspirin in both carriers and non-carriers of CYP2C19 lose-of-function alleles (all p<0.05).