{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:55:35Z","timestamp":1787810135246,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,11,7]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">This study aimed to investigate the efficacy and safety of ticagrelor\u2013aspirin versus clopidogrel\u2013aspirin in Chinese patients by the presence and clinical presentation of intracranial artery stenosis (ICAS) using randomized trial data from the CHANCE\u20102 (Clopidogrel in High\u2010Risk Patients With Acute Nondisabling Cerebrovascular Events\u2010II) trial.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 6412 patients with minor stroke or transient ischemic attack who carried\n              <jats:italic>CYP2C19<\/jats:italic>\n              loss\u2010of\u2010function alleles were randomized to either the ticagrelor\u2013aspirin or clopidogrel\u2013aspirin group. Patients without imaging of the intracranial artery were excluded from the nonprespecified subgroup analysis of CHANCE\u20102. All patients included were classified into the following groups: without ICAS, symptomatic ICAS, or asymptomatic ICAS. The primary efficacy outcome was new strokes within 90\u2009days. There were 5893 patients (median age, 64.8\u2009years; 33.9% women) included, and 172 (4.9%), 171 (10.5%), and 57 (7.7%) cases of new strokes occurred within 90\u2009days in the without ICAS, with symptomatic ICAS, and with asymptomatic ICAS groups, respectively. Ticagrelor\u2013aspirin was associated with reduced risk of new stroke in patients without ICAS (62 [3.5%] versus 110 [6.3%]; hazard ratio [HR], 0.57 [95% CI, 0.41\u20130.78]) but not in those with symptomatic ICAS (HR, 0.77 [95% CI, 0.56\u20131.05]) or in those with asymptomatic ICAS (HR, 0.77 [95% CI, 0.43\u20131.38]) compared with clopidogrel\u2013aspirin (\n              <jats:italic>P<\/jats:italic>\n              for interaction=0.14). There were no significant differences in the proportion of severe or moderate bleeding events among different ICAS groups.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients without ICAS received a significantly greater benefit from ticagrelor\u2013aspirin than clopidogrel\u2013aspirin after minor ischemic stroke or transient ischemic attack, and there was no statistically significant difference between treatments in patients with symptomatic ICAS or asymptomatic ICAS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT04078737.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.031611","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T14:07:53Z","timestamp":1698415673000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Ticagrelor Versus Clopidogrel in Minor Stroke or Transient Ischemic Attack With Intracranial Artery Stenosis: A Post Hoc Analysis of CHANCE\u20102"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1627-5004","authenticated-orcid":false,"given":"Chunjuan","family":"Wang","sequence":"first","affiliation":[{"name":"Vascular Neurology, Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital, Capital Medical University Beijing China"},{"name":"Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences Beijing China"},{"name":"National Center for Healthcare Quality Management in Neurological Diseases Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7142-1414","authenticated-orcid":false,"given":"Weili","family":"Jia","sequence":"additional","affiliation":[{"name":"Vascular Neurology, Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9822-5758","authenticated-orcid":false,"given":"Jing","family":"Jing","sequence":"additional","affiliation":[{"name":"Vascular Neurology, Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital, Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Meng","sequence":"additional","affiliation":[{"name":"Vascular Neurology, Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital, Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4351-2877","authenticated-orcid":false,"given":"Anxin","family":"Wang","sequence":"additional","affiliation":[{"name":"Vascular Neurology, Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital, Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8039-709X","authenticated-orcid":false,"given":"Qin","family":"Xu","sequence":"additional","affiliation":[{"name":"Vascular Neurology, Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital, Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinmiao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Vascular Neurology, Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital, Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3082-6789","authenticated-orcid":false,"given":"Yuesong","family":"Pan","sequence":"additional","affiliation":[{"name":"Vascular Neurology, Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital, Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8154-1957","authenticated-orcid":false,"given":"Xuewei","family":"Xie","sequence":"additional","affiliation":[{"name":"Vascular Neurology, Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital, Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2912-0714","authenticated-orcid":false,"given":"S. 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