Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Author response: Risks and benefits of clopidogrel-aspirin in minor stroke or TIA: Time course analysis of CHANCE
First author：Yuesong Pan
Corresponding author：Yongjun Wang,Yilong Wang
essential_information
- Person in charge：Yuesong Pan
- Data Sources： CHANCE
- Number of papers：CHANCE20180088
- Published time：2017-11-14
2017-11-14
Published articles
Journal：Neurology
Publication type: Original Contributions
IF(IF): 9.91
PMID: 29133611 Link To Pubmed Full text Download
Background And Purpose
To investigate the short-term time course risks and benefits of clopidogrel with aspirin in minor ischemic stroke or TIA
Method
Data were derived from the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. The primary outcome was a new ischemic stroke. Safety outcomes included any bleeding and moderate to severe bleeding. Time course analyses were performed for the outcomes of both stroke and bleeding.
Conclusion
Clopidogrel–aspirin treatment may have a benefit of reducing stroke risk outweighing the potential risk of increased bleeding especially within the first 2 weeks compared with aspirin alone in patients with minor stroke or TIA.
Main results
A total of 145 (71.1%), 13 (6.4%), and 12 (5.9%) of 204 new ischemic strokes in the clopidogrel–aspirin group vs 223 (75.6%), 19 (6.4%), and 8 (2.7%) of 295 in the aspirin alone group occurred at the first, second, and third week, respectively. A total of 23 (38.3%), 15 (25.0%), and 9 (15.0%) of 60 bleeding cases in the clopidogrel–aspirin group vs 15 (36.6%), 8 (19.5%), and 3 (7.3%) of 41 in the aspirin alone group occurred at the first, second, and third week, respectively. Clopidogrel–aspirin treatment numerically reduced the risk of ischemic stroke within the first 2 weeks. From the 10th day, the number of any bleeding cases caused by dual antiplatelets outweighed that of new stroke reduced by dual antiplatelets