​Neurology: "Ticagrelor + Aspirin" in the treatment of ischemic stroke, the benefits outweigh the disadvantages?

*For medical professionals to read and reference clinical information only, 1s touches a new study published in Neurology.
The THALES trial investigated ticagrelor combined with aspirin in the treatment of acute mild to moderate ischemic stroke or Short-term benefits and risks of transient ischemic attack (TIA)
.

How this study was done The study included 11,016 patients (5,523 in the ticagrelor plus aspirin group and 5,493 in the aspirin group), with a mean age of 65 years, of whom 39% were women
.

The cumulative incidence of irreversible efficacy and safety outcomes at different time points during the 30-day treatment period was assessed
.

Efficacy outcome (major ischemic event) was defined as a composite event of ischemic stroke or non-hemorrhagic death, safety outcome (major bleeding) was defined as a composite event of intracranial hemorrhage and fatal bleeding, and "net" clinical effect was defined for the combination of these two endpoints
.

RESULTS: Ticagrelor reduced major ischemic events in the first week (4.
1% vs 5.
3%; absolute risk reduction 1.
15%, 95% CI, 0.
36%-1.
94%) and remained lower throughout the 30-day treatment period; Major bleeding increased during the first week and remained relatively stable in subsequent weeks (absolute risk increase of approximately 0.
3%)
.

Cumulative analysis showed that the "net" clinical effect of ticagrelor plus aspirin was beneficial (absolute risk reduction 0.
97%, 95% CI, 0.
17%-1.
77%) at the first week and remained unchanged over 30 days
.

The above results show that in patients with mild to moderate ischemic stroke or high-risk TIA, the therapeutic effect of ticagrelor combined with aspirin is reflected from the first week
.

The ischemic benefit of ticagrelor plus aspirin outweighed the risk of major bleeding throughout the treatment period, a finding that may support a 30-day regimen of ticagrelor plus aspirin in these patients
.

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Time Course for Benefit and Risk of Ticagrelor and Aspirin in Acute Ischemic Stroke or Transient Ischemic Attack.
Neurology.
2022 Apr 18:10.
1212/WNL.
0000000000200355.
doi:10.
1212/WNL.
0000000000200355.
Epub.
ahead of print.
PMID:35437261