Acute Ischemic Minor Stroke and Transient Ischemic Attack
Conditions
Interventions
pharmacogenetic group:Patients randomly assigned to the pharmacogenetic group received a dose of 75 mg clopidogrel per day (ultra-metabolizers and extensive metabolizers group), 150mg clopidogrel per
standard group:P2Y12 receptor antagonist is selected by the clinician according to the clinical features of the patients.
Sponsors
Yangpu Hospital Tongji University School of Medicine
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. aged 18 years or older; 2. diagnosis of an acute minor ischemic stroke or TIA; Acute minor stroke is defined as a sudden focal neurological dysfunction caused by vascular causes, and score of 3 or less at the time of randomization on the National Institutes of Health Stroke Scale (NIHSS; scores range from 0 to 42, with higher scores indicating greater deficits). TIA is defined as a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction; 3. Onset of the acute minor ischemic stroke or TIA symptoms less than 72 h.
Exclusion criteria
Exclusion criteria: 1. hemorrhage; other conditions, such as vascular malformation, trauma, tumor, abscess, degenerative neurologic disease or other major nonischemic brain disease; 2. Systemic infectious diseases, autoimmune diseases, severe heart, liver and kidney diseases; 3. any contraindication to the use of aspirin or P2Y12 receptor antagonists; 4. prior knowledge of the patients CYP2C19*2, CYP2C19*3 or CYP2C19*17 genotype; 5. ongoing treatment in another observational or registry randomized trial; 6. an inability to provide informed consent or unavailability for follow-up. Based on the PLATO trial and PHARMCLO trial exclusion criteria, ticagrelor was contraindicated in patients: 1) with active pathological bleeding; 2) with a history of intracranial bleeding; 3) requiring dialysis; 4) taking oral anticoagulant therapy that could not be stopped; 5) with known clinically important thrombocytopenia; 6) receiving fibrinolytic therapy within the previous 24 hours; and 7) taking concomitant therapy with strong CYP3A inhibitors or inducers.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| new stroke event (ischemic or hemorrhagic); | — |
Secondary
| Measure | Time frame |
|---|---|
| ischemic stroke;hemorrhagic stroke;myocardial infarction;vascular death; | — |
Countries
China
Contacts
Public ContactYue Yun-hua
Yangpu Hospital Tongji University School of Medicine
Outcome results
None listed