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At present, the comparison of the effects of ticagrelor and clopidogrel in the secondary stroke prevention of CYP2C19 dysfunction carriers has not been widely carried out
.
Recently, a research article was published in the top medical journal NEJM.
Researchers conducted a randomized, double-blind, placebo-controlled trial in 202 centers in China, and included mild ischemic patients carrying CYP2C19 loss-of-function alleles.
Patients with stroke or transient ischemic attack (TIA)
.
The patients received ticagrelor (180 mg on day 1, and then twice a day from day 2 to day 90, each dose of 90 mg) and placebo clopidogan in a 1:1 ratio within 24 hours after the onset of symptoms.
Gray treatment, or received clopidogrel (300 mg on day 1, then 75 mg daily from day 2 to day 90) and placebo ticagrelor; both groups were treated with aspirin for 21 days
.
The main efficacy outcome of the study was new stroke, and the main safety outcome was severe or moderate bleeding within 90 days
The study screened a total of 11,255 patients and included 6,412 patients, including 3205 patients in the ticagrelor group and 3207 patients in the clopidogrel group
.
The median age of the patients was 64.
It can be seen that among Chinese patients with mild ischemic stroke or TIA with CYP2C19 loss-of-function alleles, the 90-day stroke risk after ticagrelor treatment is slightly lower than clopidogrel
.
There was no difference in the risk of severe or moderate bleeding between the two treatment groups, but ticagrelor had more total bleeding events than clopidogrel
Among Chinese patients with mild ischemic stroke or TIA with CYP2C19 loss-of-function alleles, the 90-day stroke risk after ticagrelor treatment was slightly lower than that of clopidogrel
