Dual antiplatelet therapy in stroke and ICAS: Subgroup analysis of CHANCE

Neurology
Liping LiuCHANCE Investigators

Abstract

AB OBJECTIVE: We aimed to investigate whether the efficacy and safety of clopidogrel plus aspirin vs aspirin alone were consistent between patients with and without intracranial arterial stenosis (ICAS), in the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. We assessed the interaction of the treatment effects of the 2 antiplatelet therapies among patients with and without ICAS, identified by magnetic resonance angiography (MRA) in CHANCE (ClinicalTrials.gov identifier NCT00979589). Overall, 1,089 patients with MRA images available in CHANCE were included in this subanalysis, 608 patients (55.8%) with ICAS and 481 (44.2%) without. Patients with ICAS had higher rates of recurrent stroke (12.5% vs 5.4%; p<0.0001) at 90 days than those without. But there was no statistically significant treatment by presence of ICAS interaction on either the primary outcome of any stroke (hazard ratio for clopidogrel plus aspirin vs aspirin alone: 0.79 [0.47-1.32] vs 1.12 [0.56-2.25]; interaction p=0.522) or the safety outcome of any bleeding event (interaction p=0.277). The results indicated higher rate of recurrent stroke in minor stroke or high-risk TIA patients with ICAS than in those without. ...Continue Reading

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Citations

Apr 16, 2016·Expert Review of Neurotherapeutics·Xinyi LengThomas W Leung
Jul 23, 2016·Current Cardiology Reports·David A Hoak, Helmi L Lutsep
Jan 10, 2017·International Journal of Stroke : Official Journal of the International Stroke Society·Yuehua PuLiping Liu
Mar 31, 2018·Neurological Research·Xinmiao ZhangYongjun Wang
Apr 18, 2018·International Journal of Stroke : Official Journal of the International Stroke Society·Brett R GrahamAndrew M Demchuk
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Oct 31, 2017·Current Opinion in Neurology·Xinyi LengK S Lawrence Wong
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Aug 12, 2017·Stroke; a Journal of Cerebral Circulation·Byung-Su KimGyeong-Moon Kim
Jul 7, 2017·Stroke; a Journal of Cerebral Circulation·Rajbeer S SanghaShyam Prabhakaran
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Apr 2, 2019·Stroke; a Journal of Cerebral Circulation·Dohoung KimHee-Joon Bae
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Jan 11, 2020·Journal of Neurology, Neurosurgery, and Psychiatry·Dacheng LiuLiping Liu
Jan 14, 2018·Neurology·Jiejie LiUNKNOWN CHANCE Investigators
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