JAMA Sub-Journal: On the basis of aspirin, ticagrelor vs. clopidogrel DAPT has no difference in the effect of treating stroke!

Dual antiplatelet therapy (DAPT) of clopidogrel and aspirin can effectively prevent minor ischemic stroke or recurrent stroke after transient ischemic attack (TIA)
.

Recently, some experts have suggested that evidence of ticagrelor combined with aspirin therapy is emerging, and the two DAPT regimens have not been directly compared

Dual antiplatelet therapy (DAPT) of clopidogrel and aspirin can effectively prevent minor ischemic stroke or recurrent stroke after transient ischemic attack (TIA)

JAMA

Search data from MEDLINE, Embase, and Cochrane from the beginning to February 2021
.

The study selected randomized clinical trials that recruited adults with acute minor ischemic stroke or TIA, and provided the above interventions within 72 hours after the onset of symptoms, and followed up for at least 30 days

The main result is the combined result of recurrent stroke or death within 90 days
.

Secondary outcomes include major bleeding, mortality, adverse events, and dysfunction

Results A total of 4,014 citations were screened; 5 randomized clinical trials were included
.

Data of 22,098 patients were analyzed, including 5517 in the clopidogrel and aspirin group, 5,859 in the ticagrelor and aspirin group, and 10,722 in the aspirin group

Compared with aspirin alone, clopidogrel and aspirin (HR=0.
74; 95% CrI, 0.
65-0.
84) and ticagrelor and aspirin (HR=0.
79; 95% CrI, 0.
68-0.
91) are effective in preventing recurrent stroke and The death rate was better, reducing 26% and 21% respectively
.

Compared with clopidogrel and aspirin and aspirin ticagrelor no statistically significant differences in school (the HR = 0.

Compared with aspirin alone, clopidogrel and aspirin (HR=0.

Differences in the main treatment outcomes of the three treatment groups

At the same time, the major bleeding rates of the two DAPT regimens are higher than that of aspirin alone
.

Compared with aspirin alone (HR=0.

Compared with aspirin alone (HR=0.

In summary, DAPT combined with aspirin and ticagrelor or clopidogrel is better than aspirin alone, but in terms of the main results, no statistically significant difference was found between the two regimens

references:

references:

Comparison of Ticagrelor vs Clopidogrel in Addition to Aspirin in Patients With Minor Ischemic Stroke and Transient Ischemic Attack: A Network Meta-analysis.
JAMA Neurol.
Published online December 06, 2021.
doi:10.
1001/jamaneurol.
2021.
4514

Comparison of Ticagrelor vs Clopidogrel in Addition to Aspirin in Patients With Minor Ischemic Stroke and Transient Ischemic Attack: A Network Meta-analysis.
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