国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Genotype-guided dual antiplatelet use for TIA and minor stroke by imaging status: a subgroup analysis of the CHANCE-2 trial

第一作者：Jing Jing,Xie Xuewei

通讯作者：Wang Yongjun

TIA minor stroke

基本信息

2022-12-26

已发表文章

发表杂志：Annals of neurology

发表类型: Original Contributions

影响因子(IF): 11.274

PMID: 36571569 Pubmed原文链接 全文下载

主要研究背景及目的

This study was performed to investigate whether ticagrelor/aspirin versus clopidogrel/aspirin can further reduce the residual risk of stroke recurrence in patients with positive diffusion-weighted imaging (DWI) in the High-Risk Patients with Acute Nondisabling Cerebrovascular Events II (CHANCE-2) trial.

方法

Patients with DWI data in the CHANCE-2 trial were included and divided into those with and without acute infarction according to their DWI findings. The primary efficacy outcome and safety outcome were stroke recurrence and moderate to severe bleeding within 3 months of follow-up, respectively

结论

Our study demonstrate that imaging evaluation should be emphasized before targeting the best candidates for genotype-guided dual antiplatelet therapy in future clinical research and practice.

主要结果

Of the 6412 patients enrolled in the CHANCE-2 trial, 5796 (90.4%) patients with DWI data were included in the subgroup analysis. A total of 4369 patients (75.4%) had an acute infarction on DWI. Patients with positive DWI had higher risk of recurrent stroke (8.1%) than those without infarction (2.2%) within 3-month follow-up. Compared with clopidogrel/aspirin, ticagrelor/aspirin was associated with lower risk of stroke in patients with positive DWI (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.52–0.80; P < .001) than in those negative DWI (HR, 1.22; 95% CI, 0.55–2.72; P= .63), with a significant interaction association (P for interaction = .049). The risk of moderate to severe bleeding was similar between ticagrelor/aspirin and clopidogrel/aspirin treatment in different groups.