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

Journal：Stroke

Publication type: Original Contributions

IF(IF): 8.9

PMID: PMID: 41527826 Link To Pubmed Full text Download

Previous evidence suggests that lipoprotein-associated phospholipase A2 (Lp-PLA2) may play a pivotal role in the progression of atherosclerotic lesions [1]. Ticagrelor has been observed to demonstrate endothelium-specific antithrombotic effects, which have the potential to impede the progression of arterial thrombogenesis. This particular mechanism has not been identified in clopidogrel [2]. Moreover, ticagrelor raises circulating adenosine levels, potentiating adenosine-induced coronary blood flow enhancement, with this physiological effect being modulated by endothelial cells [3]. We aimed to investigate the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in patients with minor stroke or transient ischemic attack (TIA) who carried CYP2C19 LOF alleles with different Lp-PLA2 levels.

Continuous variables were presented as mean ± SD or medians (interquartile ranges) and categorical variables as percentages. Based on previous studies, patients were divided into two groups by Lp-PLA2 activity levels (≤225 or >225 nmol/min/mL). The baseline characteristics of different groups were compared by the Kruskal-Wallis test for continuous variables and χ2 test for categorical variables. The Hazard Ratios (HRs) were calculated using the Cox regression model. The interaction of Lp-PLA2 and antiplatelet therapy was analyzed by the multivariate Cox model. Statistical significance was determined as P < 0.05, 2 sided.