{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T01:19:23Z","timestamp":1788484763056,"version":"build-2803163510"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Hypertension is a risk factor of poor stroke outcomes and associated with antiplatelet resistance. This study aimed to explore the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in patients with different hypertension status, using randomized trial data from the CHANCE-2 trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events-II).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              A total of 6412 patients with minor stroke or transient ischemic attack who carried\n              <jats:italic>CYP2C19<\/jats:italic>\n              loss-of-function alleles were enrolled and randomized to either ticagrelor-aspirin or clopidogrel-aspirin group. Hypertension status were classified into no, newly diagnosed, and previously diagnosed hypertension according to medical history, blood pressure, and antihypertensive medications during hospitalization. The primary efficacy and safety outcomes were stroke recurrence and moderate to severe bleeding risk within 90-day follow-up.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Ticagrelor-aspirin was associated with reduced risk of new stroke in patients without hypertension (32 [4.8%] versus 60 [7.2%]; hazard ratio, 0.55 [95% CI, 0.35\u20130.86]), but not in those with a newly diagnosed hypertension (20 [5.3%] versus 36 [9.1%]; hazard ratio 0.59 [95% CI, 0.33\u20131.07]), or those with a previously diagnosed hypertension (139 [7.0%] versus 147 [7.4%]; hazard ratio, 0.93 [95% CI, 0.74\u20131.18]) compared with clopidogrel-aspirin (\n              <jats:italic>P<\/jats:italic>\n              =0.04 for interaction). The risk of bleeding for ticagrelor-aspirin was not associated with hypertension status (0.1% versus 0.4%; 0.3% versus 0.5%, 0.4% versus 0.3%,\n              <jats:italic>P<\/jats:italic>\n              =0.50 for interaction). All the efficacy and safety outcomes between treatments did not differ by blood pressure levels on admission.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In the CHANCE-2 trial, patients without hypertension received a significantly greater benefit from ticagrelor- aspirin than those with previous hypertension after minor stroke or transient ischemic attack, and a similar benefit trend was observed in those with newly diagnosed hypertension.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT04078737.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.122.038662","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T09:00:29Z","timestamp":1654246829000},"page":"2799-2808","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Effect of Hypertension on Efficacy and Safety of Ticagrelor-Aspirin Versus Clopidogrel-Aspirin in Minor Stroke or Transient Ischemic Attack"],"prefix":"10.1161","volume":"53","clinical-trial-number":[{"clinical-trial-number":"nct04078737","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Anxin","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China (X.T., Y.Z.)."},{"name":"Beijing Municipal Key Laboratory of Clinical Epidemiology, China (X.T., Y.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2912-0714","authenticated-orcid":true,"given":"S. Claiborne","family":"Johnston","sequence":"additional","affiliation":[{"name":"Dell Medical School, University of Texas at Austin (S.C.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2734-5132","authenticated-orcid":true,"given":"Philip M.","family":"Bath","sequence":"additional","affiliation":[{"name":"Stroke Trials Unit, Mental Health &amp; Clinical Neuroscience, University of Nottingham, United Kingdom (P.M.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8113-8276","authenticated-orcid":true,"given":"Yingting","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China (X.T., Y.Z.)."},{"name":"Beijing Municipal Key Laboratory of Clinical Epidemiology, China (X.T., Y.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8154-1957","authenticated-orcid":true,"given":"Xuewei","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9822-5758","authenticated-orcid":true,"given":"Jing","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinxi","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2725-2788","authenticated-orcid":true,"given":"Yilong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8345-5147","authenticated-orcid":true,"given":"Xingquan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4713-5418","authenticated-orcid":true,"given":"Zixiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1465-9143","authenticated-orcid":true,"given":"Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Neurology, Seventh People\u2019s Hospital of Shanghai University of Traditional Chinese Medicine, China (F.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanxia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hejian People\u2019s Hospital, Hebei, China (Y.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panbing","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The third People\u2019s Hospital in Tongzhou District of Nantong, Jiangsu, China (P.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0339-743X","authenticated-orcid":true,"given":"Guofang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuzhou Central Hospital, Jiangsu, China (G.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"China National Clinical Research Center for Neurological Diseases, (A.W., X.M., H.L., X.X., J.J., J.L., Yilong Wang, X.Z., Z.L., Y.J., L.L., Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."},{"name":"Advanced Innovation Center for Human Brain Protection (Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the CHANCE-2 Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1412981"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.3627"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.2531"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1215340"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800410"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12111"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1586\/ern.10.203"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-04169-8"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.12551"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l2211"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.07.058"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904327"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/svn-2020-000791"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jch.13527"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/9415313"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32849-0"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309023291001"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1076029613481102"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/svn-2017-000088"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.07.044"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.110.203497"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12959-016-0100-6"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7176.2010.00307.x"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/1538574420947235"},{"key":"e_1_3_3_26_2","first-page":"289","article-title":"Prevalence and risk factors for aspirin and clopidogrel resistance in patients with coronary artery disease or ischemic cerebrovascular disease.","volume":"39","author":"Kim H","year":"2009","unstructured":"Kim, H, Lee, HK, Han, K, Jeon, HK. Prevalence and risk factors for aspirin and clopidogrel resistance in patients with coronary artery disease or ischemic cerebrovascular disease. Ann Clin Lab Sci. 2009;39:289\u2013294.","journal-title":"Ann Clin Lab Sci"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000147035.31297.b6"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000162717.62684.40"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.563056"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000105052.65787.35"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.723874"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2014.16.1.27"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30194-1"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603460"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214609"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1204133"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-154-10-201105170-00008"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.122.038662","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T08:20:49Z","timestamp":1738830049000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.122.038662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":36,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1161\/STROKEAHA.122.038662"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.122.038662","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9]]},"assertion":[{"value":"2022-01-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-20","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}