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[SOCRATES -Acute Stroke Or Transient IsChaemic Attack TReated With Aspirin or Ticagrelor and Patient OutcomES]

A Randomised, Double-Blind, Multinational Study to Prevent Major Vascular Events With Ticagrelor Compared to Aspirin (ASA) in Patients With Acute Ischaemic Stroke or TIA.

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01994720
Acronym
SOCRATES
Enrollment
13307
Registered
2013-11-26
Start date
2014-01-07
Completion date
2016-03-02
Last updated
2017-06-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Acute Ischaemic Stroke, Transient Ischaemic Attack

Keywords

Acute ischaemic stroke., Transient ischaemic attack.

Brief summary

The primary objective of the study is to compare the effect of 90-day treatment with ticagrelor (180 mg \[two 90 mg tablets\] loading dose on Day 1 followed by 90 mg twice daily maintenance dose for the remainder of the study) vs acetylsalicylic acid (ASA)-aspirin (300 mg \[three 100 mg tablets\] loading dose on Day 1 followed by 100 mg once daily maintenance dose for the remainder of the study) for the prevention of major vascular events (composite of stroke, myocardial infarction \[MI\], and death) in patients with acute ischaemic stroke or transient ischaemic attack (TIA).

Interventions

DRUGticagrelor

ticagrelor, 180 mg (two tablets of 90 mg) loading dose on Day 1 followed by 90 mg twice daily.

ASA, 300 mg (three tablets of 100 mg) on Day 1, followed by 100 mg once daily.

Sponsors

AstraZeneca
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
40 Years to 130 Years
Healthy volunteers
No

Inclusion criteria

* Men or women equal or elder 40 years of age * Either acute ischaemic stroke or high-risk TIA as defined here and randomisation occurring within 24 hours after onset of symptoms Key

Exclusion criteria

* Planned use of antithrombotic therapy in addition to study medication including antiplatelets (eg, open label ASA, GPIIb/IIIa inhibitors, clopidogrel, ticlopidine, prasugrel, dipyridamole, ozagrel, cilostazol) and anticoagulants (eg, warfarin, oral thrombin and factor Xa inhibitors, bivalirudin, hirudin, argatroban, unfractionated and low molecular weight heparins). - Any history of atrial fibrillation, ventricular aneurysm or suspicion of cardioembolic pathology for TIA or stroke. - Planned carotid, cerebrovascular, or coronary revascularisation that requires halting study medication within 7 days of randomisation. - Receipt of any intravenous or intra-arterial thrombolysis or mechanical thrombectomy within 24 hours prior to randomisation - History of previous symptomatic non-traumatic intracerebral bleed at any time (asymptomatic microbleeds do not qualify), gastrointestinal (GI) bleed within the past 6 months, or major surgery within 30 days.

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Composite of Stroke/MI/DeathFrom randomization up to 97 daysParticipants with stroke, MI or death. If no event, censoring occures at the minimum of (last date of event assessment, end of treatment date, day 97).

Secondary

MeasureTime frameDescription
Number of Participants With Ischaemic StrokeFrom randomization up to 97 daysParticipants with ischaemic stroke. If no event, censoring occures at the minimum of (last date of event assessment, date of death, end of treatment date, day 97).
Net Clinical OutcomeFrom randomization up to 97 daysParticipants with stroke, MI, death or life-threatening bleeding. If no event, censoring occures at the minimum of (last date of event assessment, end of treatment date, day 97).
Number of Participants With Composite of Ischaemic Stroke, MI and CV DeathFrom randomization up to 97 daysParticipants with ischaemic stroke, MI or CV death. If no event, censoring at the minimum of (last date of event assessment, date of death from non-CV causes, end of treatment date, day 97).
Number of Participants With All-Cause DeathFrom randomization up to 97 daysParticipants with all-cause death. If no event, censoring at the minimum of (last date of event assessment, end of treatment date, day 97).
Number of Participants With CV DeathFrom randomization up to 97 daysParticipants with CV death. If no event, censoring at the minimum of (last date of event assessment, date of death from non-CV causes, end of treatment date, day 97).
Number of Participants With MIFrom randomization up to 97 daysParticipants with MI. If no event, censoring at the minimum of (last date of event assessment, date of death, end of treatment date, day 97)
Number of Participants With Disabling StrokeFrom randomization up to 97 daysParticipants with disabling stroke. If no event, censoring at the minimum of (last date of event assessment, date of death, end of treatment date, day 97).
Number of Participants by Severity of Stroke and Overall DisabilityFrom randomization up to 97 daysAnalysis of severity of stroke and overall disability of patients, using the modified Rankin Score, mRS. Modified Rankin Score: 0 - No symptoms. 1. \- No significant disability. Able to carry out all usual activities, despite some symptoms. 2. \- Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities. 3. \- Moderate disability. Requires some help, but able to walk unassisted. 4. \- Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted. 5. \- Severe disability. Requires constant nursing care and attention, bedridden, incontinent. 6. \- Dead. Disability defined as mRS \> 1. Odds ratio and p-value are calculated for ticagrelor versus ASA from a logistic regression model with treatment group, history of stroke and NIHSS (National Institutes of Health Stroke Scale) at baseline as explanatory variables.
Number of Participants With Fatal StrokeFrom randomization up to 97 daysParticipants with fatal stroke. If no event, censoring at the minimum of (last date of event assessment, date of death from non-CV causes, end of treatment date, day 97).
Change in NIHSSFrom randomization up to 97 daysChange from baseline to end of treatment visit in NIHSS (National Institutes of Health Stroke Scale): 0 No stroke symptoms 1-4 Minor stroke 5-15 Moderate stroke 16-20 Moderate to severe stroke 21-42 Severe stroke.
EQ-5D at Visit 1 (Enrolment)Visit 1 (Enrolment)EQ-5D (EuroQol five dimensions questionnaire) index score using the UK tariff. EQ-5D is a self assessment of 5 dimensions: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. For each dimension responders are asked to state their status on a three level ordinal scale; whether they experience no problems (Level 1), some problems (Level 2) or severe problems (Level 3). Health states defined by the 5 dimensions can be converted into a weighted health state index (health state utility) by applying scores from the EQ-5D value sets elicited from general population samples. The higher the index score the better the health state. In this study index scores ran from -0.59 to 1.
EQ-5D at Visit 2 (Day 7+-2d)Visit 2 (Day 7+-2d)EQ-5D (EuroQol five dimensions questionnaire) index score using the UK tariff. EQ-5D is a self assessment of 5 dimensions: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. For each dimension responders are asked to state their status on a three level ordinal scale; whether they experience no problems (Level 1), some problems (Level 2) or severe problems (Level 3). Health states defined by the 5 dimensions can be converted into a weighted health state index (health state utility) by applying scores from the EQ-5D value sets elicited from general population samples. The higher the index score the better the health state. In this study index scores ran from -0.59 to 1.
EQ-5D (EuroQol Five Dimensions Questionnaire) at End of Treatment VisitEnd of treatment visit (Day 90+-7d)EQ-5D index score using the UK tariff. EQ-5D is a self assessment of 5 dimensions: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. For each dimension responders are asked to state their status on a three level ordinal scale; whether they experience no problems (Level 1), some problems (Level 2) or severe problems (Level 3). Health states defined by the 5 dimensions can be converted into a weighted health state index (health state utility) by applying scores from the EQ-5D value sets elicited from general population samples. The higher the index score the better the health state. In this study index scores ran from -0.59 to 1.
EQ-5D (EuroQol Five Dimensions Questionnaire) at Premature Treatment Discontinuation VisitPremature treatment discontinuation visit(<15 days after last dose)EQ-5D index score using the UK tariff. EQ-5D is a self assessment of 5 dimensions: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. For each dimension responders are asked to state their status on a three level ordinal scale; whether they experience no problems (Level 1), some problems (Level 2) or severe problems (Level 3). Health states defined by the 5 dimensions can be converted into a weighted health state index (health state utility) by applying scores from the EQ-5D value sets elicited from general population samples. The higher the index score the better the health state. In this study index scores ran from -0.59 to 1.
Number of Participants With PLATO Major Bleeding EventFrom randomization up to 97 daysParticipants with PLATO Major bleeding. If no event, censoring occures at the minimum of (last date of event assessment, date of death, end of treatment date, day 97). PLATO Major bleeding is defined as a bleed that is any one of: * Fatal * Intracranial (excluding asymptomatic haemorrhagic transformations of ischemic brain infarctions and excluding micro-hemorrhages \<10 mm evident only on gradient-echo MRI) * Intrapericardial bleed with cardiac tamponade * Hypovolaemic shock or severe hypotension due to bleeding and requiring pressors or surgery * Significantly disabling (eg. intraocular with permanent vision loss) * Clinically overt or apparent bleeding associated with a decrease in Hb of more than 30 g/L (1.9 mmol/L; 0.465 mmol/L) * Transfusion of 2 or more units (whole blood or packed red blood cells \[PRBCs\]) for bleeding.
Number of Participants With Premature Discontinuation of Study Drug Due to Any Bleeding Adverse EventTime from first dose and up to and including 7 days following the date of last dose of the studyParticipants discontinuation of study drug due to any bleeding adverse event. If no event, censoring occures at the minimum of (last date of event assessment, date of death, end of treatment date, day 97).
Number of Participants With StrokeFrom randomization up to 97 daysParticipants with stroke. If no event, censoring at the minimum of (last date of event assessment, date of death, end of treatment date, day 97)

Countries

Argentina, Australia, Belgium, Brazil, Bulgaria, Canada, Chile, China, Czechia, France, Germany, Hong Kong, Hungary, Israel, Italy, Japan, Mexico, Peru, Philippines, Poland, Romania, Russia, Slovakia, South Korea, Spain, Sweden, Switzerland, Taiwan, Thailand, Turkey (Türkiye), Ukraine, United States, Vietnam

Participant flow

Recruitment details

In total, 13307 patients were enrolled from 674 study sites in 33 countries. The first patient was enrolled on 07 January 2014. The last patient visit took place on 02 March 2016.

Pre-assignment details

Enrolled patients randomised to study drug: 99.2%; n=13199 Patients who were not randomised: 0.8%; n=108 Patients with eligibility criteria not fulfilled: 0.7%; n=93 Patient decision: 0.1%; n=15

Participants by arm

ArmCount
Ticagrelor 90 mg
Ticagrelor 90 mg twice daily (BD)
6,589
ASA 100 mg
ASA 100 mg once daily (OD)
6,610
Total13,199

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyWithdrawal by Subject4656

Baseline characteristics

CharacteristicTicagrelor 90 mgASA 100 mgTotal
Age, Continuous65.8 Years
STANDARD_DEVIATION 11.23
65.9 Years
STANDARD_DEVIATION 11.37
65.9 Years
STANDARD_DEVIATION 11.3
Age, Customized
<65 years
3021 Participants3007 Participants6028 Participants
Age, Customized
>75 years
1504 Participants1491 Participants2995 Participants
Age, Customized
Between 65 and 75 years
2064 Participants2112 Participants4176 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
566 Participants558 Participants1124 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
6023 Participants6050 Participants12073 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants2 Participants2 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
69 Participants74 Participants143 Participants
Race/Ethnicity, Customized
Asian
1957 Participants1949 Participants3906 Participants
Race/Ethnicity, Customized
Black or African American
119 Participants120 Participants239 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
4 Participants1 Participants5 Participants
Race/Ethnicity, Customized
Other
66 Participants56 Participants122 Participants
Race/Ethnicity, Customized
White
4374 Participants4410 Participants8784 Participants
Sex: Female, Male
Female
2759 Participants2724 Participants5483 Participants
Sex: Female, Male
Male
3830 Participants3886 Participants7716 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
85 / 6,581383 / 6,549
serious
Total, serious adverse events
533 / 6,581532 / 6,549

Outcome results

Primary

Number of Participants With Composite of Stroke/MI/Death

Participants with stroke, MI or death. If no event, censoring occures at the minimum of (last date of event assessment, end of treatment date, day 97).

Time frame: From randomization up to 97 days

Population: The population was the full analysis set, which included all randomized patients.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants With Composite of Stroke/MI/Death442 Participants
ASA 100 mgNumber of Participants With Composite of Stroke/MI/Death497 Participants
Comparison: Composite of stroke/MI/deathp-value: 0.06795% CI: [0.78, 1.01]Regression, Cox
Secondary

Change in NIHSS

Change from baseline to end of treatment visit in NIHSS (National Institutes of Health Stroke Scale): 0 No stroke symptoms 1-4 Minor stroke 5-15 Moderate stroke 16-20 Moderate to severe stroke 21-42 Severe stroke.

Time frame: From randomization up to 97 days

Population: NIHSS in patients with an index stroke event

ArmMeasureGroupValue (NUMBER)
Ticagrelor 90 mgChange in NIHSSMissing474 Participants
Ticagrelor 90 mgChange in NIHSS228 Participants
Ticagrelor 90 mgChange in NIHSS318 Participants
Ticagrelor 90 mgChange in NIHSS<=-5132 Participants
Ticagrelor 90 mgChange in NIHSS-4403 Participants
Ticagrelor 90 mgChange in NIHSS-3779 Participants
Ticagrelor 90 mgChange in NIHSS-21088 Participants
Ticagrelor 90 mgChange in NIHSS-11099 Participants
Ticagrelor 90 mgChange in NIHSS0681 Participants
Ticagrelor 90 mgChange in NIHSS167 Participants
Ticagrelor 90 mgChange in NIHSS413 Participants
Ticagrelor 90 mgChange in NIHSS56 Participants
Ticagrelor 90 mgChange in NIHSS>510 Participants
ASA 100 mgChange in NIHSS411 Participants
ASA 100 mgChange in NIHSS-11131 Participants
ASA 100 mgChange in NIHSS231 Participants
ASA 100 mgChange in NIHSS>514 Participants
ASA 100 mgChange in NIHSS316 Participants
ASA 100 mgChange in NIHSS0683 Participants
ASA 100 mgChange in NIHSS<=-5127 Participants
ASA 100 mgChange in NIHSS56 Participants
ASA 100 mgChange in NIHSS-4438 Participants
ASA 100 mgChange in NIHSS179 Participants
ASA 100 mgChange in NIHSS-3810 Participants
ASA 100 mgChange in NIHSSMissing450 Participants
ASA 100 mgChange in NIHSS-21073 Participants
Secondary

EQ-5D at Visit 1 (Enrolment)

EQ-5D (EuroQol five dimensions questionnaire) index score using the UK tariff. EQ-5D is a self assessment of 5 dimensions: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. For each dimension responders are asked to state their status on a three level ordinal scale; whether they experience no problems (Level 1), some problems (Level 2) or severe problems (Level 3). Health states defined by the 5 dimensions can be converted into a weighted health state index (health state utility) by applying scores from the EQ-5D value sets elicited from general population samples. The higher the index score the better the health state. In this study index scores ran from -0.59 to 1.

Time frame: Visit 1 (Enrolment)

Population: Include only results from patients who visit the site in-person.

ArmMeasureValue (MEAN)Dispersion
Ticagrelor 90 mgEQ-5D at Visit 1 (Enrolment)0.70 Index scoreStandard Deviation 0.297
ASA 100 mgEQ-5D at Visit 1 (Enrolment)0.70 Index scoreStandard Deviation 0.298
Secondary

EQ-5D at Visit 2 (Day 7+-2d)

EQ-5D (EuroQol five dimensions questionnaire) index score using the UK tariff. EQ-5D is a self assessment of 5 dimensions: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. For each dimension responders are asked to state their status on a three level ordinal scale; whether they experience no problems (Level 1), some problems (Level 2) or severe problems (Level 3). Health states defined by the 5 dimensions can be converted into a weighted health state index (health state utility) by applying scores from the EQ-5D value sets elicited from general population samples. The higher the index score the better the health state. In this study index scores ran from -0.59 to 1.

Time frame: Visit 2 (Day 7+-2d)

Population: Include only results from patients who visit the site in-person.

ArmMeasureValue (MEAN)Dispersion
Ticagrelor 90 mgEQ-5D at Visit 2 (Day 7+-2d)0.80 Index scoreStandard Deviation 0.244
ASA 100 mgEQ-5D at Visit 2 (Day 7+-2d)0.79 Index scoreStandard Deviation 0.262
Secondary

EQ-5D (EuroQol Five Dimensions Questionnaire) at End of Treatment Visit

EQ-5D index score using the UK tariff. EQ-5D is a self assessment of 5 dimensions: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. For each dimension responders are asked to state their status on a three level ordinal scale; whether they experience no problems (Level 1), some problems (Level 2) or severe problems (Level 3). Health states defined by the 5 dimensions can be converted into a weighted health state index (health state utility) by applying scores from the EQ-5D value sets elicited from general population samples. The higher the index score the better the health state. In this study index scores ran from -0.59 to 1.

Time frame: End of treatment visit (Day 90+-7d)

Population: Include only results from patients who visit the site in-person.

ArmMeasureValue (MEAN)Dispersion
Ticagrelor 90 mgEQ-5D (EuroQol Five Dimensions Questionnaire) at End of Treatment Visit0.85 Index scoreStandard Deviation 0.203
ASA 100 mgEQ-5D (EuroQol Five Dimensions Questionnaire) at End of Treatment Visit0.84 Index scoreStandard Deviation 0.208
Secondary

EQ-5D (EuroQol Five Dimensions Questionnaire) at Premature Treatment Discontinuation Visit

EQ-5D index score using the UK tariff. EQ-5D is a self assessment of 5 dimensions: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. For each dimension responders are asked to state their status on a three level ordinal scale; whether they experience no problems (Level 1), some problems (Level 2) or severe problems (Level 3). Health states defined by the 5 dimensions can be converted into a weighted health state index (health state utility) by applying scores from the EQ-5D value sets elicited from general population samples. The higher the index score the better the health state. In this study index scores ran from -0.59 to 1.

Time frame: Premature treatment discontinuation visit(<15 days after last dose)

Population: Include only results from patients who visit the site in-person. The Premature Treatment Discontinuation visit (PTDV) is only done for patients who prematurely and permanently stop study medication.

ArmMeasureValue (MEAN)Dispersion
Ticagrelor 90 mgEQ-5D (EuroQol Five Dimensions Questionnaire) at Premature Treatment Discontinuation Visit0.72 Index scoreStandard Deviation 0.33
ASA 100 mgEQ-5D (EuroQol Five Dimensions Questionnaire) at Premature Treatment Discontinuation Visit0.68 Index scoreStandard Deviation 0.364
Secondary

Net Clinical Outcome

Participants with stroke, MI, death or life-threatening bleeding. If no event, censoring occures at the minimum of (last date of event assessment, end of treatment date, day 97).

Time frame: From randomization up to 97 days

Population: The population was the full analysis set, which included all randomized patients.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNet Clinical Outcome457 Participants
ASA 100 mgNet Clinical Outcome508 Participants
p-value: 0.092895% CI: [0.79, 1.02]Regression, Cox
Secondary

Number of Participants by Severity of Stroke and Overall Disability

Analysis of severity of stroke and overall disability of patients, using the modified Rankin Score, mRS. Modified Rankin Score: 0 - No symptoms. 1. \- No significant disability. Able to carry out all usual activities, despite some symptoms. 2. \- Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities. 3. \- Moderate disability. Requires some help, but able to walk unassisted. 4. \- Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted. 5. \- Severe disability. Requires constant nursing care and attention, bedridden, incontinent. 6. \- Dead. Disability defined as mRS \> 1. Odds ratio and p-value are calculated for ticagrelor versus ASA from a logistic regression model with treatment group, history of stroke and NIHSS (National Institutes of Health Stroke Scale) at baseline as explanatory variables.

Time frame: From randomization up to 97 days

Population: The population was the full analysis set which included all randomized patients.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants by Severity of Stroke and Overall Disability1107 Participants
ASA 100 mgNumber of Participants by Severity of Stroke and Overall Disability1194 Participants
p-value: 0.139395% CI: [0.85, 1.02]Regression, Logistic
Secondary

Number of Participants With All-Cause Death

Participants with all-cause death. If no event, censoring at the minimum of (last date of event assessment, end of treatment date, day 97).

Time frame: From randomization up to 97 days

Population: The population was the full analysis set, which included all randomized patients.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants With All-Cause Death68 Participants
ASA 100 mgNumber of Participants With All-Cause Death58 Participants
p-value: 0.364195% CI: [0.83, 1.67]Regression, Cox
Secondary

Number of Participants With Composite of Ischaemic Stroke, MI and CV Death

Participants with ischaemic stroke, MI or CV death. If no event, censoring at the minimum of (last date of event assessment, date of death from non-CV causes, end of treatment date, day 97).

Time frame: From randomization up to 97 days

Population: The population was the full analysis set, which included all randomized patients.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants With Composite of Ischaemic Stroke, MI and CV Death423 Participants
ASA 100 mgNumber of Participants With Composite of Ischaemic Stroke, MI and CV Death475 Participants
p-value: 0.077195% CI: [0.78, 1.01]Regression, Cox
Secondary

Number of Participants With CV Death

Participants with CV death. If no event, censoring at the minimum of (last date of event assessment, date of death from non-CV causes, end of treatment date, day 97).

Time frame: From randomization up to 97 days

Population: The population was the full analysis set, which included all randomized patients.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants With CV Death41 Participants
ASA 100 mgNumber of Participants With CV Death35 Participants
p-value: 0.482895% CI: [0.75, 1.85]Regression, Cox
Secondary

Number of Participants With Disabling Stroke

Participants with disabling stroke. If no event, censoring at the minimum of (last date of event assessment, date of death, end of treatment date, day 97).

Time frame: From randomization up to 97 days

Population: The population was the full analysis set, which included all randomized patients.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants With Disabling Stroke277 Participants
ASA 100 mgNumber of Participants With Disabling Stroke307 Participants
p-value: 0.212695% CI: [0.77, 1.06]Regression, Cox
Secondary

Number of Participants With Fatal Stroke

Participants with fatal stroke. If no event, censoring at the minimum of (last date of event assessment, date of death from non-CV causes, end of treatment date, day 97).

Time frame: From randomization up to 97 days

Population: The population was the full analysis set, which included all randomized patients.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants With Fatal Stroke18 Participants
ASA 100 mgNumber of Participants With Fatal Stroke17 Participants
p-value: 0.855795% CI: [0.55, 2.06]Regression, Cox
Secondary

Number of Participants With Ischaemic Stroke

Participants with ischaemic stroke. If no event, censoring occures at the minimum of (last date of event assessment, date of death, end of treatment date, day 97).

Time frame: From randomization up to 97 days

Population: The population was the full analysis set, which included all randomized patients.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants With Ischaemic Stroke385 Participants
ASA 100 mgNumber of Participants With Ischaemic Stroke441 Participants
Comparison: Ischemic strokep-value: 0.046295% CI: [0.76, 1]Regression, Cox
Secondary

Number of Participants With MI

Participants with MI. If no event, censoring at the minimum of (last date of event assessment, date of death, end of treatment date, day 97)

Time frame: From randomization up to 97 days

Population: The population was the full analysis set, which included all randomized patients.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants With MI25 Participants
ASA 100 mgNumber of Participants With MI21 Participants
p-value: 0.545795% CI: [0.67, 2.14]Regression, Cox
Secondary

Number of Participants With PLATO Major Bleeding Event

Participants with PLATO Major bleeding. If no event, censoring occures at the minimum of (last date of event assessment, date of death, end of treatment date, day 97). PLATO Major bleeding is defined as a bleed that is any one of: * Fatal * Intracranial (excluding asymptomatic haemorrhagic transformations of ischemic brain infarctions and excluding micro-hemorrhages \<10 mm evident only on gradient-echo MRI) * Intrapericardial bleed with cardiac tamponade * Hypovolaemic shock or severe hypotension due to bleeding and requiring pressors or surgery * Significantly disabling (eg. intraocular with permanent vision loss) * Clinically overt or apparent bleeding associated with a decrease in Hb of more than 30 g/L (1.9 mmol/L; 0.465 mmol/L) * Transfusion of 2 or more units (whole blood or packed red blood cells \[PRBCs\]) for bleeding.

Time frame: From randomization up to 97 days

Population: The population was the safety analysis set, which included all patients who received at least 1 dose of randomized ticagrelor or ASA and for whom post-dose data are available.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants With PLATO Major Bleeding Event31 Participants
ASA 100 mgNumber of Participants With PLATO Major Bleeding Event38 Participants
Comparison: PLATO Major bleedingp-value: 0.451195% CI: [0.52, 1.34]Regression, Cox
Secondary

Number of Participants With Premature Discontinuation of Study Drug Due to Any Bleeding Adverse Event

Participants discontinuation of study drug due to any bleeding adverse event. If no event, censoring occures at the minimum of (last date of event assessment, date of death, end of treatment date, day 97).

Time frame: Time from first dose and up to and including 7 days following the date of last dose of the study

Population: The population was the safety analysis set, which included all patients who received at least 1 dose of randomized ticagrelor or ASA and for whom post-dose data are available.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants With Premature Discontinuation of Study Drug Due to Any Bleeding Adverse Event82 Participants
ASA 100 mgNumber of Participants With Premature Discontinuation of Study Drug Due to Any Bleeding Adverse Event37 Participants
p-value: <0.000195% CI: [1.53, 3.34]Regression, Cox
Secondary

Number of Participants With Stroke

Participants with stroke. If no event, censoring at the minimum of (last date of event assessment, date of death, end of treatment date, day 97)

Time frame: From randomization up to 97 days

Population: The population was the full analysis set, which included all randomized patients.

ArmMeasureValue (NUMBER)
Ticagrelor 90 mgNumber of Participants With Stroke390 Participants
ASA 100 mgNumber of Participants With Stroke450 Participants
p-value: 0.034295% CI: [0.75, 0.99]Regression, Cox

Source: ClinicalTrials.gov · Data processed: Mar 13, 2026